Spiral ct lung cancer screening can help save lives current smokers (or former smokers who quit in the past 15 years) and those who smoke about 30 packs of cigarettes a year can participate in lung cancer screening but cancer screening can be scary if your loved ones qualify for lung cancer. Recommended screening for lung cancer is done with a test called a low-dose helical or spiral computed tomography (ct or cat) scan a ct scan creates a 3-dimensional picture of the inside of the body with an x-ray machine. Lung cancer is the main cause of death from malignancies due to the high prevalence and adverse prognosis when diagnosis is established in symptomatic patients with early diagnosis, survival is.
A spiral ct scan costs $300 or more insurance usually pays for the test for lung cancer screening only if you have a very high risk for developing lung cancer and the test often leads to other costs. The type of low-dose ct scan that is recommended for lung cancer screening is a newer form of ct scan known as a low-dose spiral or helical ct scan the low-dose spiral ct scan continuously rotates in a spiral motion and takes several 3-dimensional x-rays of the lungs. The california technology assessment forum is requested to review the scientific evidence for the use of low dose spiral computerized tomography (ldct) as a modality for lung cancer screening. Low-radiation-dose unenhanced spiral computed tomography (“low-dose ct”) is believed to represent the technique closest to practical application for mass screening due to its high sensitivity for small non-calcified pulmonary nodules, the most common manifestation of early lung cancer.
This feature is not available right now please try again later. Screening with low-dose spiral ct scans has been shown to decrease the risk of dying from lung cancer in heavy smokers the national lung screening trial studied people aged 55 years to 74 years who had smoked at least 1 pack of cigarettes per day for 30 years or more. While spiral computed tomography is proposed as an alternative to chest x-ray and high resolution ct in the screening of lung cancer, published clinical trials do not provide evidence to support the efficacy of spiral ct over conventional.
Screening smokers and former smokers for lung tumors using three-dimensional x-rays reduced their risk of dying from lung cancer by 20 percent, researchers said on thursday. The uspstf recommends annual screening for lung cancer with low-dose computed tomography (ldct) in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Lung cancer screening by chest radiography did not lead to a decrease in lung cancer mortality, presumably because the chest radiograph is a poor screening tool with low sensitivity with the advent of the low-dose spiral computed tomography (ct) scan it has become feasible to detect early invasive stage i lung cancer in 80–90% of cases. Introduction lung cancer has the highest mortality rate of cancers in japan early detection is necessary to improve its whether population-based mass screening with a spiral computed tomography scanner could contribute substantially to detection of smaller cancers, and decrease mortality. The mayo clinic group presented a proposal of a randomized comparison of spiral ct versus chest x-ray for lung cancer screening the study would be conducted on a high-risk group, ie, participants age 50 and older who are current smokers or people who stopped smoking within the past ten years.
Ct lung screening is a noninvasive, painless procedure that uses low-dose x-rays to screen the lungs for cancer in just 30 seconds a ct lung screening allows the radiologist to look at different levels, or slices, of the lungs using a rotating x-ray beam. A low-dose ct lung screening can help find abnormalities in the lungs that may need follow-up evaluation for risk of lung cancerthe ultra low-dose ct scan demonstrates the lung tissue in high diagnostic quality detail with a reduced amount of ionizing radiation. Lung cancer screening is done using an imaging machine to produce a low-dose spiral (or helical) ct (computed tomography) scan of the chest this scan uses a series of x-rays to show the shape, size and location of anything abnormal in the chest that might signal the need for follow up. Spiral computerized tomography (ldct) as a modality for lung cancer screening this is an update of the review conducted in 2000 for the blue shield of california medical policy committee on quality and technology.
The uk lung screening trial also used spiral ct to screen current and ex-smokers for lung cancer it found that spiral ct scans could diagnose lung cancer early but more research is needed to find out whether a programme like this can save lives. Abstract background: low-dose spiral computed tomography (sct) showed a four-fold increase in the detection rate in high-risk subjects and a higher percentage of stage i lung cancer in comparison with chest x-ray however, there is a considerable discrepancy among studies in the percentage of lung nodules, overall lung cancer and stage i detection rate. The national lung screening trial (nlst) by national cancer institute (nci) results show mortality benefit with low-dose ct, twenty percent fewer lung cancer deaths seen among those who were screened with low-dose spiral ct than with chest x-ray. Spiral computed tomography (ct) scanning, also known as helical ct or low- dose ct scanning, is a covered service for annual screening for lung cancer in high-risk patients when all of the following are met.


Clinical Excellence Research Center
The first university-based research center exclusively dedicated to discovering, testing, and evaluating cost-saving innovations in clinically excellent care. Our research seeks more affordable ways to deliver better care for conditions consuming the bulk of the country's healthcare spending.
CERC's Response to COVID-19
The Covid-19 crisis is challenging CERC’s faculty, scholars, and fellows to rapidly develop innovations that lower the cost of clinically excellent infectious disease care. Additionally, our Partnership in AI-Assisted Care, with faculty and graduate students from the computer science department, is moving ahead with computer vision applications to ease the burden on clinicians striving to deliver exceptional COVID care to ICU patients.
A Message From The Director
"Federal creditworthiness and therefore American prosperity now hinge on continuously attaining better health with less health spending. By rapidly mobilizing emerging science and technology from engineering, management, and medicine, the Clinical Excellence Research Center will enable Stanford to help solve a seemingly intractable national challenge."
- Arnold Milstein, MD, MPH
Dr. Milstein founded CERC after two decades of improving healthcare value in the private sector and advising the White House and Congress. He is now training America's next generation of healthcare innovators to remove wasteful and dangerous inefficiencies that ail the U.S. health-care system.
CERC NEWS & PUBLICATIONS
NEJM , July 1 2020
While it may be tempting to blame the plunge in hospitals’ profitability on the COVID-19 pandemic, the problem can be linked to hospital business strategies that began two decades ago, according to researchers at Stanford University.
NEJM Catalyst , June 2020
Former CERC fellows Francesca Rinaldo, MD, PhD, Myra Altman, PhD, and Kendell Cannon, MD, highlight three care delivery innovations to better meet the needs of older adults and reduce health spending.
HMPI , June 1, 2020
Stanford Hospital implemented a COVID-19 Critical Care Task Force (CCTF) to provide real-time institutional and regional guidance on patient care and surge planning during the COVID-19 pandemic.
MedPage Today, May 15, 2020
Multiple factors at play: testing capacity, case definitions, age distribution, preparedness
MedPage Today May 12, 2020
Public health has taken a back seat to clinical diagnosis for too long
NEJM Catalyst, May 11, 2020
Health care organizations can benefit from decades of cross-industry research


Repolarization abnormalities in survivors of out-of-hospital ventricular fibrillation.
Survivors of out-of-hospital ventricular fibrillation (VF) are at high risk for recurrent VF, probably reflecting continued myocardial electrical instability. In this study 12-lead ECGs of 125 VF survivors with coronary heart disease were examined and compared to those of 98 ambulatory post-MI patients. The study was part of an effort to define clinical identifiers of patients likely to develop sudden cardiac death. Ventricular fibrillation survivors were commonly had premature ventricular complexes (PVCs):30% versus 13% (P less than 0.01). In addition, ECGs of VF survivors showed a significantly greater prevalence of ST-segment depression (46% versus 10%), T wave flattening (52% versus 26%), and QTc prolongation (35% versus 18%). It is proposed that these repolarization abnormalities represent asynchronous repolarization, which together with frequent PVCs, may set the stage for re-entrant ventricular dysrhythmias and ultimately VF. It is also possible that repolarization abnormalities together with premature ventricular contractions might serve as markers of patients with coronary heart disease who are at increased risk for sudden cardiac death.
- Copyright © 1978 by American Heart Association


For coverage approval, typically health insurers require documentation to (which may vary by insurer) include:
- Adult age
- A diagnosis of Major Depressive Disorder (MDD), Moderate to Severe severity
- Validation and measurement of the diagnosis and depression severity using a standardized rating scale (commonly the PHQ-9, which mirrors the DSM criteria for MDD)
- Failure of 3 to 4 antidepressants during the current episode, with documentation of dosages, start & stop dates, and response to each
- Failure of a course of validated psychotherapy during the current episode
- Prior authorization from the insurer before starting
Initiating TMS Treatment
The process for initiating rTMS treatment typically includes:
- Gathering preliminary information on prior treatment trials and health status for safety and insurance approval
- Having in place releases of information to communicate with all medical and mental health providers for continuity of care.
- Performing an assessment to verify appropriateness and safety of treatment
Formulating a plan to manage any medical comorbidities, such as the existence of any implantable electrical devices or metal in the body
- The only firm contraindication to treatment with TMS is the presence of any ferromagnetically sensitive object in the head area.
- Obtaining informed consent for treatment, including a discussion of expectations and the known potential risks, side effects and benefits, including that effectiveness is not guaranteed
- The most medically concerning known side effect is the possibility of inducing seizures
Treatment typically requires:
- Commitment and dedication to your own recovery. Response, like many antidepressant treatments, is typically seen weeks into the stimulation.
- Daily transportation.
- Payment of associated fees and copays (our office will assist in clarifying this for you)
- Treatment is required almost every weekday for 9 weeks. This customarily includes 6 weeks of acute treatment 5 days per week, followed by a 3-week taper of thrice weekly for 1 week, twice weekly for one week, then once the last week.
- The first day of treatment lasts longer, because time must be taken to determine the motor threshold (MT) and map the appropriate treatment location
- Psychotropic medications are often maintained during and after treatment, especially of there has a been a partial response
- Near daily interaction with a, experienced, knowledgeable and supportive treatment team, and frequent monitoring by the administering physician, aids in safety and recovery


From lip balm to gummies and even beer, CBD – or cannabidiol – has captured the wallets of millions. Once controversial, CBD is now touted as a cure-all, from helping to calm nerves to fighting depression and anxiety. And it’s made its way into our coffees, lunches and moisturisers – with an overall market estimated to hit nearly PS1 billion by 2025.
CBD is a compound that’s found in the cannabis plant but doesn’t make you high – so it’s legal and widely available on the UK high street and online. It’s used by an estimated quarter of a million regular users to help ease symptoms of chronic pain, anxiety and sleep problems.
Despite the huge popularity, some are concerned that CBD products may not be as effective as they claim to be. The industry has attracted “CBD cowboys” – opportunists who are selling unregulated and often ineffective products, according to experts. And lab tests from the Centre for Medicinal Cannabis in June revealed that 62 per cent of products on the high street didn’t have the amount of CBD advertised on their label, and some actually contained traces of THC, which is a controlled substance.
The most popular form of CBD is in oil, to be dropped under the tongue or added to food and drink. But you can also get it in capsules, muscle gels, sprays and e-liquids for vaping, with a range of flavours. Typically it’s sold at high street health stores such as Holland and Barrett, and online. A 500mg bottle of oral drops can cost up to PS45, and a jar of edible oils or creams could be more than twice as much.
In addition to CBD products, it’s also possible to buy cannabis-based medicine on prescription as medicinal cannabis if you have a severe medical condition such as rheumatoid arthritis or multiple sclerosis. But specific cannabis-based medicines only have a small chance of helping, and can have side effects including dizziness, dry mouth, nausea and tiredness.
As a result, many people choose to use non-medical cannabis and CBD products for the symptomatic relief of their symptoms – with some evidence that they can help reduce anxiety, insomnia and pain. Others may find it helps them to relax or sleep better, and can help with other conditions such as inflammatory diseases like rheumatoid arthritis, or the effects of epilepsy.
The results of this survey are based on the responses from 1,415 UK residents aged 18 and over who have bought and/or consumed CBD (Cannabidiol) wellness products in the past two years. Of these, the vast majority of respondents were in the age bracket 35-54 years and most were female.
Please note, the majority of current over the counter CBD wellness products require Novel Foods validation to be sold in the UK. However, this is changing from April 2021. We have therefore asked respondents whether they believe that over the counter CBD products will continue to be more or less expensive than the authorised medical cannabis via prescription charge from NHS England, following the introduction of this change. UK CBD


How Anti-Inflammatory Diets, Iron, B12 & Vitamin D Foods Can Impact Enterprisesby DAVIS BROWN PRC Agency
It costs the U.S. economy hundreds of billions of dollars per year in poor health and almost 2/3 of the cost is lost productivity due to workplace absenteeism and low performance. That is, employees report to work, however, poor health restricts them from functioning at peak performance.
There is no doubt that the 2020 pandemic with millions of sick people around the world will have a significant impact on employee's health and productivity, thus depleting human resources.
As economies around the world struggle to reopen with less than full capacity, it is more important than ever for companies to take a proactive role and invest in the health and wellness of their employees.
While Mainstream Media and Government around the world are stressing mandatory use of "masks" and "social distancing" as businesses slowly reopen, they neglect the root cause of poor health and they fail to address the importance of having a STRONG IMMUNE SYSTEM.
It is now time for businesses to take an active role to ensure their most valuable asset, "human resources," is functioning at peak performance, making the health and wellness of employees a top priority.
A healthy immune system will not prevent anyone getting respiratory sickness, however, it may make the difference between being sick for a few days or several weeks. There are numerous studies which shows that investing in a healthy workforce can have profound impact on the bottom line and also the best employees are recognizing the importance of their employers to take a vested interest in the well being of their staff.
There are many tech companies and new startup companies that go above and beyond to help employees live a more healthy lifestyle and this year, more than ever, to attract the best employees, companies will have to take a more active role in their staff's health and wellness.
The demand for companies to be more involved in the health and wellness of their employees, this will result in training companies offering a wide range of courses on how to boost the immune system and how to care for the human frame.
“The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.” - Thomas Edison
Manos Filippou, author, research guru, and one of the top instructors at UDEMY with over 25,000 students, dug deep and what would be an entire year of study, he has consolidated the important elements on how to boost the immune system, in ONE single course.
The course "Be Proactive: How to Boost Your Immune System, Live and Prosper" is the most well-researched training program with hundreds of science-based evidence, and a clear mission to help companies educate their employees to build resilience and boost their immunity, giving them a competitive advantage. In addition, the course aims to educate individuals who are afraid to visit a doctor due to potential high medical costs, as well, those who lack access to primary care.
Supported by hundreds of credible and authoritative resources from health organizations and the government sectors, this course has everything employees and their families need to know to boost their immune system. It includes immune system booster foods including vitamin D foods, foods high in iron, vitamin B12 foods, and foods high in magnesium. Also gut health, anti-inflammatory diets, antioxidants, lifestyle choices, things to avoid, and important immune system strategies NEVER considered before! All under ONE very well thought out course.
Being proactive and taking care of their employees is a smart strategy for any size of company. It can impact a company's bottom line by giving them a competitive advantage, and often it can make the difference between life or death.
As economies around the world struggle to reopen, and hundreds of billions of dollars are lost in the corporate world due to sick costs, it is imperative in 2020 for companies to be proactive and invest in the health and wellness of their employees. "Be Proactive: How to Boost Your Immune System, Live and Prosper" is a the most well-researched training program with science-based evidence to help companies educate their employees to build resilience and boost immunity.
HERE ARE A FEW TOPICS COVERED IN THE COURSE:
#1. CORPORATIONS CAN AVOID HIGH HEALTH COSTS BY TAKING A PROACTIVE APPROACH TOWARD THE HEALTH OF THEIR EMPLOYEES.
Smart, forward thinking companies who care for the well being of their employees and the future of their organization need to take a proactive approach to make sure their employees have access to all the tools they need to support their health. A strong immune system can potentially prevent future health pro
Created on Aug 6th 2020 10:43. Viewed 413 times.


Genetic variants in MYBPC3 are one of the most common causes of hypertrophic cardiomyopathy (HCM). While variants in MYBPC3 affecting canonical splice site dinucleotides are a well-characterised cause of HCM, only recently has work begun to investigate the pathogenicity of more deeply intronic variants. Here, we present three patients with HCM and intronic splice-affecting MYBPC3 variants and analyse the impact of variants on splicing using in vitro minigene assays. We show that the three variants, a novel c.927-8G>A variant and the previously reported c.1624+4A>T and c.3815-10T>G variants, result in MYBPC3 splicing errors. Analysis of blood-derived patient RNA for the c.3815-10T>G variant revealed only wild type spliced product, indicating that mis-spliced transcripts from the mutant allele are degraded. These data indicate that the c.927-8G>A variant of uncertain significance and likely benign c.3815-10T>G should be reclassified as likely pathogenic. Furthermore, we find shortcomings in commonly applied bioinformatics strategies to prioritize variants impacting MYBPC3 splicing and re-emphasize the need for functional assessment of variants of uncertain significance in diagnostic testing.


News Flash Home
The original item was published from 2/24/2014 10:47:26 AM to 3/1/2015 12:15:00 AM.
Posted on: February 24, 2014
[ARCHIVED] PROPER HANDWASHING: THE BEST WAY TO PREVENT THE SPREAD OF NOROVIRUS
MEMPHIS – Outbreaks of the common and highly contagious gastrointestinal virus known as norovirus have been recently confirmed by the Shelby County Health Department (SCHD), prompting health officials to encourage individuals to take the proper precaution


The number of COVID-19 patients being treated in Connecticut hospitals has spiked to 500 as the number of unvaccinated filling beds continues to rise.
In his latest update from the state Department of Health, 80 more patients were admitted to Connecticut hospitals over the weekend as the number of new post-Thanksgiving infections being reported is surging.
Of the 500 patients who are hospitalized, 386 (77.2 percent) are not fully vaccianted, according to Connecticut Gov. Ned Lamont.
According to state health officials, in the past week, unvaccinated people in Connecticut had a 4.5-times greater risk of testing positive for COVID-19 compared to fully vaccinated persons.
Unvaccinated people also had a 31.1-times greater risk of dying from COVID-19, as the death toll rose to 8,909 since the pandemic began in March 2020.
In the latest update from the Department of Health, 94,544 COVID-19 tests were administered in Connecticut over the weekend, resulting in 5,481 laboratory-confirmed cases of the virus for a 5.80 percent positive infection rate.
There have been more than 700 new daily infections reported in Connecticut for more than three weeks as the state deals with new variants of the virus.
A breakdown of which populations have received the most vaccines, by age group according to the latest update:
- 65+: >95 percent
- 55-64: 94 percent;
- 45-54: 85 percent;
- 35-44: 86 percent;
- 25-34: 79 percent;
- 18-24: 73 percent;
- 16-17: 81 percent;
- 12-15: 73 percent;
- 5-11: 24 percent.
The latest breakdown of confirmed COVID-19 cases in Connecticut since March 2020, by county:
- Fairfield: 116,976 (12,400 per 100,000 residents);
- New Haven: 110,848 (12,968);
- Hartford: 104,086 (11,672);
- New London: 30,126 (11,359);
- Litchfield: 18,747 (10,396);
- Middlesex: 15,932 (9,808);
- Windham: 14,931 (12,785);
- Tolland: 12,174 (8,077).
A complete list of cases, by communities, can be found here by clicking and scrolling down.
Click here to sign up for Daily Voice's free daily emails and news alerts.


- Research article
- Open Access
Changes in frailty among community-dwelling Chinese older adults and its predictors: evidence from a two-year longitudinal study
BMC Geriatrics volume 20, Article number: 130 (2020)
It is important to clarify the transitions and related factors of frailty for prevention of frailty. We evaluated the transitions of frailty among community-dwelling older adults and examined the predictors of the transitions.
A cohort study was conducted among 3988 community residents aged ≥60 years during 2015 and 2017. A multiple deficits approach was used to construct the Frailty Index (FI) according to the methodology of FI construction, and sociodemographic characteristics and lifestyles were also collected in 2015. After 2-year follow-up, the transitions of frailty between baseline and were evaluated. Multinomial logistic regressions were used to examine associations between predictors and the transitions of frailty.
The proportion of robust, prefrail, and frail was 79.5, 16.4, and 4.1% among 3988 participants at baseline, which changed to 68.2, 23.0, and 8.8% after 2 years with 127 deaths and 23 dropped out. Twelve kinds of transitions from the three frailty statuses at baseline to four outcomes at follow-up (including death) significantly differed within each of gender and age group, as well between genders and age groups. Among these, 7.8% of prefrail or frail elders improved, 70.0% retained their frailty status, and 22.2% of robust or prefrail elders worsened in frailty status. In multivariable models, age was significantly associated with changes in frailty except for in the frail group; higher educational level and working predicted a lower risk of robust worsening. Of the lifestyle predictors, no shower facilities at home predicted a higher risk of robust worsening; more frequent physical exercise predicted a lower risk of robust worsening and a higher chance of frailty improvement; more frequent neighbor interaction predicted a lower risk of robust worsening and prefrail worsening; and more frequent social participation predicted a higher chance of prefrail improvement.
The status of frailty was reversible among community-dwelling elderly, and sociodemographic and lifestyle factors were related to changes in frailty. These findings help health practitioners to recognize susceptible individuals in a community and provide health promotional planning to target aged populations.
Frailty is an unstable status with the age-related loss of physiological reserves and disorders in homeostatic systems [1, 2]. The presence of frailty is not only symptomatic in older individuals, but it also renders them more prone to downstream changes in long-term health outcomes, such as disability, hospitalization, institutionalization, and mortality [1, 3,4,5,6]. In the absence of a gold standard, the two approaches most widely used are frailty phenotype (FP)  and frailty index (FI) . FP is defined on the basis of weight loss, exhaustion, physical activity, walk time, and grip strength, while FI is defined as an individual’s accumulated proportion of listed health-related deficits. Based on the used definitions, the prevalence of frailty ranges from 4.0 to 59.1% in community-dwelling older adults,  and both FP and FI can effectively predict adverse outcomes . An exponential correlation has been shown between FI and age, [7, 10] and the heterogeneity of physiological reserves trends to be greater in later life . The approach of FI represents a continuous status of health,  which is more likely to demonstrate the dynamic nature of frailty in the general aged population. Frailty among older adults is generally agreed to be a dynamic status [13,14,15] that is inevitable with increasing age but reversible, [16, 17] and it may represent an intermediate stage between healthiness and the end of life as a biological age [1, 10]. It is conceivable that FI could also represent the cumulative effect of multiple individuals and environmental factors from a health ecological perspective. Understanding the characteristics related to frailty transitions will allow for better future health practice and healthcare strategies.
Several studies have reported on the natural transitions in frailty status and their factors, which are mostly associations with sociodemographic factors and health status [17,18,19,20,21,22,23,24]. For instance, those who are older, [17, 19, 23, 24] have fewer years of education,  have diabetes and previous stroke,  have poor functional performance, [19, 21, 24] and have cognitive impairment  are associated with frailty worsening. These findings are helpful for health practitioners to recognize susceptible individuals, though they seem inadequate to provide health promotional planning for community aged populations. Identifying the social and behavioral factors that may worsen or improve frailty would contribute to establishing appropriate measures to prevent or delay frailty progression in a broader-aged population. Numerous studies have shown an association between lifestyle factors and frailty [25,26,27,28]. However, few studies have examined the relationship between potential social and behavioral factors and changes in frailty.
Recently, a longitudinal study provided evidence that older Chinese living in communities that have a higher percentage of green space had a higher likelihood of improvement in frailty status, and physical activity presented a mediation effect . It is widely recognized that there are close associations between social and behavioral factors and health outcomes, and various studies have demonstrated them to be effective interventions for the frail elderly, including physical exercise and social support [2, 30,31,32]. It is reasonable to believe that an individual’s lifestyle has an important influence on changes in frailty. Moreover, a 15-year longitudinal study showed that an index constructed by multiple lifestyle protective factors is associated with a lower risk of worsening frailty and a greater chance of recovery among Chinese community-dwelling older adults . However, the independent effects of each factor are unknown, and additional lifestyle factors that are easy to modify need to be explored and their protective effects on frailty tested in future studies.
Based on these considerations, we investigated how changes in frailty occurred among community-dwelling older Chinese through a 2-year cohort study, and lifestyle factors associated with changes in frailty were identified.
Study design and participants
This was a longitudinal observational study among Chinese older adults living in the community of Shanghai. Multi-stage random sampling was used to select subjects. Two of 11 streets were randomly selected, and then four communities were randomly selected from each street. Simple random sampling was used to select family, in which older adults aged ≥60 years lived in through a household registration information system. Residents aged ≥60 years among selected families were all approached to participate in the investigation. Written informed consent was obtained from each study participant, and the Research Ethics Committee of the Division for the Prevention and Control of Chronic Non-communicable Diseases, China Center for Disease Control and Prevention, approved the study protocol. A total of 4050 participants aged ≥60 years were originally recruited for an investigation of chronic diseases and geriatric syndromes in 2015. After eliminating invalid answers to questionnaires, the valid response proportion was 98.5% (3988/4050). Finally, the average age and its standard deviation (SD) of participants was 69.38 (7.06), with 43.5% male, 79.8% married, and more than half never educated (as shown in Table 1). During the next 2 years, there were 127 deaths and 23 participants lost to follow-up. Of those who were lots to follow-up, were unable to recontact them and some may have emigrated to another city. Five of these participants had prefrail and 18 had robust status.
Frailty index construction and frailty transitions
According to the methodology of FI construction, a multiple deficits approach was used to construct the FI. Deficits were defined as “symptoms, signs, disabilities, and diseases,” which prevalence must increase with age . Thirty-six eligible items were eventually selected covering the self-reported presence of current diseases (5 items), cognitive and mental symptoms (9 items), ability in the activities of daily living (15 items), as well as physical and neurological signs (7 items) (Details in Additional file 1). All items for FI were dichotomized into the presence (1) or absence (0) of a frailty deficit. The FI was calculated as the proportion of the number of deficits for an individual to the maximum total number of deficits. According to previous studies, [23, 35] we categorized the FI score into a three-level variable: robust (FI ≤ 0.10), prefrail (0.10 < FI ≤ 0.21), and frail (FI > 0.21). Frailty transitions were included for the three kinds of frailty status (robust, prefrail, and frail) changing into to each other among survivors after 2 years, which were defined as worsening, stability, or improvement. Outcomes also included death from each of the three kinds of frailty status.
Sociodemographic factors included age (Years), gender (Male/Female), educational level (Illiteracy/Primary school/Junior high school or above), marital status (Married/Unmarried; ‘Unmarried’ included never married, divorced, and widowed), and working status (Yes/No; ‘Yes’ means an individual still works for payment or for free, such as a volunteer, and ‘No’ means an individual has retired or has no work).
Lifestyle factors included living alone (Yes/No), has a shower facility at home (Yes/No), annual physical examination (Yes/No), cigarette smoking (Current smoker, Former smoker, Nonsmoker), alcohol intake (Yes/No; ‘Yes’ means an individual drinks sometimes or more often, and ‘No’ means an individual never drinks), daily tea (Yes/No), reading (Yes/No; ‘Yes’ means an individual reads books or newspapers sometimes or more often, and ‘No’ means an individual almost never reads), plays cards or mahjong (Yes/No; ‘Yes’ means an individual plays cards or mahjong sometimes or more often, and ‘No’ means an individual almost never plays), physical exercise (Almost never/Several times per week/Everyday; ‘Almost never’ means an individual does exercises over 10 min for only several times per month or less, ‘Several times per week’ means an individual does exercises over 10 min for 1–6 days, ‘Everyday’ means an individual does exercises over 10 min everyday), meeting with children (Almost never/Several times per week/Everyday; ‘Almost never’ means an individual meets with children for only several times per month or less), neighbor interaction (Almost never/Several times per week/Everyday; ‘Almost never’ means an individual interacts with neighbors over 10 min for only several times per month or less), and social participation (Almost never/Several times per month/Several times per week; ‘Almost never’ means an individual takes part in various social activities for several times per year or never). Alcohol intake was selected single frequency domain from quantity frequency scale (QF), regularly screening patients for alcohol problems by primary care doctors, and was degreed answer into non-drinker (never drinking at all) and drinker (some times and more often) . Physical exercise was designed categorized answers according to absolute physical measurements, which aims to quickly classify physical exercise level . The number and proportion of each lifestyle variable is presented in Table 1.
Descriptive statistics for demographic and lifestyle variables are presented as the frequency and percentage, continuous variables are described as means and SD, and the Chi-square test was used to evaluate the distribution of the three kinds of frailty status at baseline between groups according to demographics and lifestyle. The health outcomes after 2 years and the three kinds of frailty transitions were also described and compared according to gender and age. Multinomial logistic regressions were used to explain whether the 2-year change of frailty was associated with lifestyle factors, with unadjusted and adjusted coefficients both reported. Windows-based SPSS version 22.0 (SPSS Inc., Chicago, IL, USA) was used for all of the statistical analysis, and a P value of less than 0.05 was considered to be statistically significant.
Table 1 showed the participants’ sociodemographic and lifestyle factors, and a comparison of these factors among the three frailty statuses at baseline. Prefrail and frail female elders were more common than males, while there were similar proportions of robust male and female elders. The average age of the frail, prefrail, and robust elders significantly increased. Except for meeting with children, all of the lifestyle factors were correlated with the frailty status at baseline. As expected, lifestyle protective factors included married, higher educational level, working, daily tea, reading, playing cards or mahjong, physical exercise, neighbor interaction, and social participation; and risk factors were live alone, lacking shower facilities at home, and no annual physical examination. However, there were higher proportions of current smokers and alcohol drinkers among the robust elders.
There were twelve kinds of transitions from baseline of the three frailty statuses to 2-year follow-up of four outcomes (including 127 deaths). Figure 1 shows the results of frailty status transitions according to gender (a) and age (b). The frailty status transitions significantly differed within each of gender and age group and also significantly differed between gender and age groups. Table 2 shows the changes in frailty among the 2-year survivors: 7.8% (299/3838), 70.0% (2687/3838), and 22.2% (852/3838) of elders improved (improvement), stayed the same (stability), and worsened (worsening) in frailty status, respectively. Among the baseline robust and prefrail elders, female elders (robust: 29.3% vs. 17.2%; prefrail: 21.0% vs. 16.3%), and older elders (robust: 49.8% vs. 34.4% vs. 16.6%) had a higher risk of frailty worsening, while there were no statistically significant differences between gender and age groups among the baseline frail elders. In further multivariate analyses, there were no significant associations between changes in frailty and gender, and the associations between age and the three changes in frailty were significant except for in the frail group.
Table 3 shows the results of univariate (unadjusted models) and multivariate (adjusted models) analyses between lifestyle predictors and changes in frailty. Unadjusted and adjusted ORs and their 95% CI were used to estimate the risk of worsening and improvement compared to stability among the three kinds of baseline frailty status, respectively. In the unadjusted models, except for annual physical examination and meeting with children, all of the lifestyle factors were associated with robust worsening, while only neighbor interaction was associated with prefrail worsening. In addition, marital status, education, living alone, shower facilities at home, smoking, daily tea, reading, and social participation were associated with prefrail improvement, and physical exercise and neighbor interaction were associated with frail improvement.
After all of the variables were entered into the model and additional adjustments for age and gender were applied, associations between frailty transitions and several factors weakened or disappeared. In particular, 1) those robust elders who had higher educational levels (compared with illiteracy, primary school: OR = 0.63, 95% CI: 0.51~0.78; junior high school or above: OR = 0.46, 95% CI: 0.33~0.64), still at work (OR = 0.60, 95% CI: 0.45~0.80), had more frequent physical exercise (compared with almost never, several times per week: OR = 0.73, 95% CI: 0.55~0.96; everyday: OR = 0.72, 95% CI: 0.58~0.90) and more neighbor interaction (compared with almost never, everyday: OR = 0.67, 95% CI: 0.51~0.87) predicted a lower risk of robust worsening, while having no shower facilities at home (OR = 1.39, 95% CI: 1.02~1.90) predicted a higher risk of robust worsening; 2) those prefrail elders who had more neighbor interaction (compared with almost never, several times per week: OR = 0.30, 95% CI: 0.13~0.74; everyday: OR = 0.52, 95% CI: 0.27~1.00) predicted a lower risk of prefrail worsening; 3) only more frequent social participation (compared with almost never, several times per week: OR = 2.14, 95% CI: 1.08~4.24) predicted a higher chance of prefrail improvement; and 4) among frail elders, only more physical exercise (compared with almost never, everyday: OR = 4.03, 95% CI: 1.42~11.46) predicted a higher chance of frailty improvement.
The present study showed that frailty status can deteriorate to a worse state (22.2%) but can also turn back to a better state (7.8%), though the majority stayed in the same state (70.0%). These results are similar to previous studies, [33, 38, 39] and continue to support the notion that frailty is a dynamic and reversible status in later life . With increasing age, the risk of being frailty and frailty worsening were both higher. Older females have widely been found to have a higher prevalence of frailty, [2, 8, 41] which also showed in our study. In addition, the decline rate among robust and prefrail female elders was found to be higher than in males. However, after adjusting for lifestyle factors, it seemed that few differences in changes of frailty were consistent with previous studies [18, 39]. These findings suggest that females probably have worse health but a more protective lifestyle, which provides a reason for the health-survival paradox. A higher educational level, known to promote better psychological well-being and less dependence,  was found to be associated with decreasing frailty among baseline robust elders in a previous study  and in the current study.
This study found that, beyond stability, improvement in frailty status is possible, and those elders who were frail at baseline improved by 18.3% in males and 36.0% in females during a period of 2 years. Older adults who had physical exercise everyday had a four-fold chance of frailty improvement compared to those who almost never exercised, and those who had frequent physical exercise had a nearly 27% lower risk of robust worsening in this study. Various physical activities are associated with health, and a number of random control trials have demonstrated the benefit of exercise intervention for the frail elderly [30,31,32]. These encouraging findings support the idea that the maintenance of robustness and improvements in frailty status can be promoted through daily physical exercise.
Among the robust elders at baseline, those who worked and had more frequent neighbor interaction had a 40 and 33% decreased risk of frailty worsening, respectively. A comparison study found that older workers experience a greater sense of mastery than retired elders,  which may encourage additional correct choices related to health . A sense of mastery, as a powerful psychological resource, is strongly linked to positive mental and physical health outcomes . A lower frequency of social interactions is associated with feelings of loneliness and depression,  and neighbor interactions are also an important way for older adults to acquire social resources (e.g., health information, emotional and instrumental support), which may serve as important buffers for frailty worsening. This is consistent with the decreased frailty worsening by frequent neighbor interaction among prefrail elders. In addition, taking part in social activities frequently seemed to be beneficial for prefrail elders. The presence of health problems is more likely to attract their attention, and those who participated in social activities frequently may have more chances to access health knowledge, increase physical activity, and promote interpersonal relationships, all of which favor health .
Finally, we also found that baseline robust elders whose home does not have shower facilities predicted a higher risk of frailty worsening compared to those with showers. A lack of shower facilities at home could be an obstacle to personal hygiene, especially for older people, which may decrease their quality of life. However, it could simply reflect poor indoor conditions, which are likely to lead to adverse health outcomes.
Strengths and limitations
Associations between lifestyle and frailty has been widely reported, but its influence on changes in frailty is unclear. This study is one of the few that has explored the relationship between various types of lifestyle factors and changes in frailty. This was a large longitudinal observational study with a very low dropout rate: 0.6% (n = 23), and to the best of our knowledge, this study is one of a few to demonstrate a relationship between lifestyle factors and changes in frailty.
However, several limitations should be also mentioned. First, all of the analytical data in the study were from self-reported measures, instead of more accurate laboratory and clinical tests. Even so, self-reported data have been suggested to be valid by numerous publications. Second, assessments for each lifestyle factor only referred to a single aspect, and many other aspects of these lifestyle factors have not been considered. For instance, 1) other facilities or characteristics related to assisted ageing could be considered in the assessment of indoor conditions for the elderly; 2) other dietary habits (e.g., vegetable intake, fruit intake) could also be included; and 3) for social participation (physical exercise, interactions, and activities), the frequency of participation is important, but the satisfaction and style of participation should not be ignored [46, 47]; these are potential reasons for the different results among different frailty statuses. Finally, the study sample was drawn from the Shanghai area, which is one of the most developed cities in China, and it might not represent other parts of China.
This longitudinal population-based study suggests that the status of frailty was reversible among community-dwelling elderly, and lifestyle protective factors were likely to decrease the risk of frailty worsening. Although several health behaviors were not separately significantly related to changes in frailty, cumulative protective factors are associated with a lower risk of frailty deterioration or mortality, as well as a greater chance of recovery . Of the lifestyle predictors, many more factors were found to be associated with changes in frailty among robust and prefrail elders than frail elders, which suggests that early identification and intervention have a bigger chance of maintaining or delaying declines related to frailty status. These findings help health practitioners to recognize susceptible individuals in a community and provide health promotional planning to target aged populations.
Availability of data and materials
The data that support the findings of this study are available from The National Center for Chronic and Noncommunicable Disease Control and Prevention but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of The National Center for Chronic and Noncommunicable Disease Control and Prevention.
Statistical Package for the Social Sciences
United States of America
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.
Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752–62.
Rockwood K, Howlett SE, MacKnight C, Beattie BL, Bergman H, Hebert R, Hogan DB, Wolfson C, McDowell I. Prevalence, attributes, and outcomes of fitness and frailty in community-dwelling older adults: report from the Canadian study of health and aging. J Gerontol A Biol Sci Med Sci. 2004;59(12):1310–7.
Song X, Mitnitski A, Rockwood K. Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation. J Am Geriatr Soc. 2010;58(4):681–7.
Romero-Ortuno R, Kenny RA. The frailty index in Europeans: association with age and mortality. Age Ageing. 2012;41(5):684–9.
Hyde Z, Flicker L, Smith K, Atkinson D, Fenner S, Skeaf L, Malay R, Giudice DL. Prevalence and incidence of frailty in aboriginal Australians, and associations with mortality and disability. Maturitas. 2016;87:89–94.
Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. ScientificWorldJournal. 2001;1:323–36.
Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc. 2012;60(8):1487–92.
Malmstrom TK, Miller DK, Morley JE. A comparison of four frailty models. J Am Geriatr Soc. 2014;62(4):721–6.
Mitnitski AB, Graham JE, Mogilner AJ, Rockwood K. Frailty, fitness and late-life mortality in relation to chronological and biological age. BMC Geriatr. 2002;2(1):1–1.
WHO. WHO Clinical Consortium on Healthy Ageing. Topic focus: frailty and intrinsic capacity. Genava: World Health Organization; 2016.
Rockwood K, Mitnitski A. Frailty in relation to the accumulation of deficits. J Gerontol A Biol Sci Med Sci. 2007;62(7):722–7.
Abellan Van Kan G, Rolland Y, Bergman H, Morley JE, Kritchevsky SB, Vellas B. The I.A.N.A. task force on frailty assessment of older people in clinical practice. J Nutr Health Aging. 2008;12(1):29–37.
Lang P-O, Michel J-P, Zekry D. Frailty syndrome: a transitional state in a dynamic process. Gerontology. 2009;55(5):539–49.
Morley JE, Vellas B, Abellan Van Kan G, Anker SD, Bauer JM, Bernabei R, Cesari M, Chumlea WC, Doehner W, Evans J, et al. Frailty consensus: a call to action. JAMDA. 2013;14(6):392–7.
Espinoza SE, Jung I, Hazuda H. Frailty transitions in the San Antonio longitudinal study of aging. J Am Geriatr Soc. 2012;60(4):652–60.
Lee JSW, Auyeung T-W, Leung J, Kwok T, Woo J. Transitions in frailty states among community-living older adults and their associated factors. JAMDA. 2014;15(4):281–6.
Ottenbacher KJ, Graham JE, Al Snih S, Raji M, Samper-Ternent R, Ostir GV, Markides KS. Mexican Americans and frailty: findings from the Hispanic established populations epidemiologic studies of the elderly. Am J Public Health. 2009;99(4):673–9.
Fallah N, Mitnitski A, Searle SD, Gahbauer EA, Gill TM, Rockwood K. Transitions in frailty status in older adults in relation to mobility: a multistate modeling approach employing a deficit count. J Am Geriatr Soc. 2011;59(3):524–9.
Alencar MA, Dias JMD, Figueiredo LC, Dias RC. Transitions in Frailty Status in Community-Dwelling Older Adults. Opics Geriatr Rehab. 2015;31(2):105–12.
Pollack LR, Litwack-Harrison S, Cawthon PM, Ensrud K, Lane NE, Barrett-Connor E, Dam T-T. Patterns and predictors of frailty transitions in older men: the osteoporotic fractures in men study. J Am Geriatr Soc. 2017;65(11):2473–9.
Trevisan C, Veronese N, Maggi S, Baggio G, Toffanello ED, Zambon S, Sartori L, Musacchio E, Perissinotto E, Crepaldi G, et al. Factors influencing transitions between frailty states in elderly adults: the Progetto Veneto Anziani longitudinal study. J Am Geriatr Soc. 2017;65(1):179–84.
Thompson MQ, Theou O, Adams RJ, Tucker GR, Visvanathan R. Frailty state transitions and associated factors in south Australian older adults. Geriatr Gerontol Int. 2018;18(11):1549–55.
Setiati S, Laksmi PW, Aryana I, Sunarti S, Widajanti N, Dwipa L, Seto E, Istanti R, Ardian LJ, Chotimah SC. Frailty state among Indonesian elderly: prevalence, associated factors, and frailty state transition. BMC Geriatr. 2019;19(1):182.
Poli S, Cella A, Puntoni M, Musacchio C, Pomata M, Torriglia D, Vello N, Molinari B, Pandolfini V, Torrigiani C, et al. Frailty is associated with socioeconomic and lifestyle factors in community-dwelling older subjects. Aging Clin Exp Res. 2017;29(4):721–8.
Brinkman S, Voortman T, Kiefte-de JJ, van Rooij F, Ikram MA, Rivadeneira F, Franco OH, Schoufour JD. The association between lifestyle and overall health, using the frailty index. Arch Gerontol Geriatr. 2018;76:85–91.
Tanimura C, Matsumoto H, Tokushima Y, Yoshimura J, Tanishima S, Hagino H. Self-care agency, lifestyle, and physical condition predict future frailty in community-dwelling older people. Nurs Health Sci. 2018;20(1):31–8.
Ye B, Gao J, Fu H. Associations between lifestyle, physical and social environments and frailty among Chinese older people: a multilevel analysis. BMC Geriatr. 2018;18(1):314.
Yu R, Wang D, Leung J, Lau K, Kwok T, Woo J. Is neighborhood green space associated with less frailty? Evidence from the Mr. and Ms. Os (Hong Kong) study. JADMA. 2018;19(6):528–34.
Ng TP, Feng L, Nyunt MSZ, Feng L, Niti M, Tan BY, Chan G, Khoo SA, Chan SM, Yap P, et al. Nutritional, Physical, Cognitive, and Combination Interventions and Frailty Reversal Among Older Adults: A Randomized Controlled Trial. Am J Med. 2015;128(11):1225–36 e1221.
Luger E, Dorner TE, Haider S, Kapan A, Lackinger C, Schindler K. Effects of a Home-Based and Volunteer-Administered Physical Training, Nutritional, and Social Support Program on Malnutrition and Frailty in Older Persons: A Randomized Controlled Trial. JADMA. 2016;17(7):671.e679–16.
Tarazona-Santabalbina FJ, Gómez-Cabrera MC, Pérez-Ros P, Martínez-Arnau FM, Cabo H, Tsaparas K, Salvador-Pascual A, Rodriguez-Mañas L, Viña J. A multicomponent exercise intervention that reverses frailty and improves cognition, emotion, and social networking in the community-dwelling frail elderly: a randomized clinical trial. JADMA. 2016;17(5):426–33.
Wang C, Song X, Mitnitski A, Fang X, Tang Z, Yu P, Rockwood K. Effect of health protective factors on health deficit accumulation and mortality risk in older adults in the Beijing longitudinal study of aging. J Am Geriatr Soc. 2014;62(5):821–8.
Searle SD, Mitnitski A, Gahbauer EA, Gill TM, Rockwood K. A standard procedure for creating a frailty index. BMC Geriatr. 2008;8(1):24.
Hoover M, Rotermann M, Sanmartin C, Bernier J. Validation of an index to estimate the prevalence of frailty among community-dwelling seniors. Health Rep. 2013;24(9):10–7.
Cherpitel CJ. Screening for alcohol problems in the U.S. general population: comparison of the CAGE, RAPS4, and RAPS4-QF by gender, ethnicity, and service utilization. Rapid alcohol problems screen. Alcohol Clin Exp Res. 2002;26(11):1686–91.
Gill DP, Jones GR, Zou GY, Speechley M. Using a single question to assess physical activity in older adults: a reliability and validity study. BMC Med Res Methodol. 2012;12:20. https://doi.org/10.1186/1471-2288-12-20.
Liu ZY, Wei YZ, Wei LQ, Jiang XY, Wang XF, Shi Y, Hai H. Frailty transitions and types of death in Chinese older adults: a population-based cohort study. Clin Interv Aging. 2018;13:947–56.
Martin L, McKenzie K, Ouellette-Kuntz H. Once frail, always frail? Frailty transitions in home care users with intellectual and developmental disabilities. Geriatr Gerontol Int. 2018;18(4):547–53.
Gill TM, Gahbauer EA, Allore HG, Han L. Transitions between frailty states among community-living older persons. Arch Intern Med. 2006;166(4):418–23.
He B, Ma Y, Wang C, Jiang M, Geng C, Chang X, Ma B, Han L. Prevalence and risk factors for frailty among community-dwelling older people in China: a systematic review and meta-analysis. J Nutr Health Aging. 2019;23(5):442–50.
Santos-Eggimann B, Cuenoud P, Spagnoli J, Junod J. Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. J Gerontol A Biol Sci Med Sci. 2009;64A(6):675–81.
Nyqvist F, Forsman AK, Cattan M. A comparison of older workers' and retired older people's social capital and sense of mastery. Scand J Public Health. 2013;41(8):792–8.
Pudrovska T, Schieman S, Pearlin LI, Nguyen K. The sense of mastery as a mediator and moderator in the association between economic hardship and health in late life. J Aging Health. 2016;17(5):634–60.
Domènech-Abella J, Lara E, Rubio-Valera M, Olaya B, Moneta MV, Rico-Uribe LA, Ayuso-Mateos JL, Mundó J, Haro JM. Loneliness and depression in the elderly: the role of social network. Soc Psychiatry Psychiatr Epidemiol. 2017;52(4):381–90.
Duppen D, Lambotte D, Dury S, Smetcoren AS, Pan H, De Donder L, Consortium DS: Social Participation in the Daily Lives of Frail Older Adults: Types of Participation and Influencing Factors. J Gerontol B Psychol Sci Soc Sci 2019, bz045, https://doi.org/https://doi.org/10.1093/geronb/gbz045.
Kwan RYC, Cheung DSK, Lo SKL, Ho LYW, Katigbak C, Chao Y-Y, Liu JYW. Frailty and its association with the Mediterranean diet, life-space, and social participation in community-dwelling older people. Geriatr Nurs. 2019;40(3):320–6.
We thank the contributions of the investigators during the 2 years, and thank LetPub (www.letpub.com) for its linguistic assistance during the preparation of this manuscript.
This work was supported by the National key R&D Program of China (grant number: 2018YFC2002000 & 2018YFC2002001). The funding bodies had no specific role in study design or data collection, analysis, and interpretation, or manuscript conception and writing.
Ethics approval and consent to participate
The Research Ethics Committee of the Division for the Prevention and Control of Chronic Non-communicable Diseases, China Center for Disease Control and Prevention, approved the study protocol.
Consent for publication
The authors declare no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Ye, B., Chen, H., Huang, L. et al. Changes in frailty among community-dwelling Chinese older adults and its predictors: evidence from a two-year longitudinal study. BMC Geriatr 20, 130 (2020). https://doi.org/10.1186/s12877-020-01530-x
- Frailty index
- Change of frailty
- Older adults


October 30, 1997 |
Hundreds of residents who received flu shots at clinics in Monroe, Conn., are worried that they might have been exposed to viruses that cause hepatitis and AIDS, health officials said. They said many residents lined up for recommended hepatitis B shots after the scare. The shots are being given as a precaution because the town's health director, who has since resigned, did not change the syringe between flu shots that he gave to about 468 people.
October 7, 2002 |
A growing number of doctors are now convinced that for many people, too much iron in the blood is a bigger health problem than too little. "For years we were getting, 'Rah, rah, the more iron the better.' Now that has changed around completely," said Richard Stevens, a cancer epidemiologist at University of Connecticut Health Center who has studied the potential health risks of elevated levels of iron.
April 20, 1993 |
Cigna Sues NME, Claims Fraud: Cigna Corp. said it has sued National Medical Enterprises Inc., alleging that the psychiatric hospital operator committed widespread insurance fraud against the Connecticut health insurer. The suit, filed in U.S. District Court in Dallas on March 24, seeks repayment of millions of dollars of patient treatment charges that it alleges were billed fraudulently. Equitable Life Assurance Society of the United States, based in New York, is also a plaintiff in the suit.
CALIFORNIA | LOCAL
October 10, 1988 |
An experimental contraceptive vaccine has blocked fertility without fail in female and male guinea pigs, researchers report, raising prospects that a similar approach might work for women and men. The vaccine is designed to prevent fertilization, which may make it more widely acceptable than another vaccine already being tested in humans that stops development of the embryo, other scientists said.
August 4, 1994
After more than a century of girding the loins of American male athletes--and giving its name to those who wear it--the jock is slipping. Although the jock alone may be an endangered species, it's still issued by many college and pro teams. And protective cups, both hard and soft--with cup supporters that, with any luck, keep them in position--have never gone out of style in contact sports. But novel fabrics and designs have helped to create a new generation of athletic underwear.
April 13, 2011 |
A representative for Catherine Zeta-Jones confirmed Wednesday that the actress recently underwent inpatient treatment for bipolar II disorder at a Connecticut mental health facility. Booster Shots spoke about the disorder with David J. Miklowitz, PhD, a professor of psychiatry at the UCLA School of Medicine and author of "The Bipolar Disorder Survival Guide: What You and Your Family Need to Know. " Bipolar disorder, formerly known as manic-depression, is typically lifelong and recurrent, Miklowitz said. Some people have their first episode in childhood, others later in life; the majority, during the teen years. Some people experience episodes every few years; others are in and out of episodes constantly.


Did you know that slow-healing wounds can prevent you from taking part in your daily chores because they are very painful? Some wounds are not severe, but due to poor or inappropriate care, they worsen to chronic wounds resulting in severe complications like bone infection. That is why qualified and experienced specialists like Dr. Ashley Huddleston in Forth Worth take proactive steps to promote wound healing. Comprehensive care that includes advanced dressing, nutrition, and specialized treatment like hyperbaric oxygen therapy is used. Below is all you are required to know concerning wound care.
When do you need wound care?
Wounds that require professional care have developed an infection or are severe wounds. Similarly, you also require wound care for wounds that do not heal quickly. In most cases, you are said to have a chronic wound or a non-healing wound when it has not started healing for about two weeks or has failed to heal completely within six weeks. But if you develop an ulcer on your foot or lower leg, you shouldn’t wait to see if it will heal because ulcers rarely heal on their own. And with time, ulcers only worsen and develop complications.
What types of wounds require professional care?
Some wounds that require professional wound care are infected, venous leg ulcers, diabetic wounds, foot ulcers, pressure sores, arterial ulcers, or surgical wound complications. Non-healing wounds can take several months to heal. In this case, the longer the wound takes to heal, the more you risk having serious infections that can invade the surrounding bones and skin. Amputation can be done in very severe and chronic wounds.
What are the symptoms that indicate you need wound care?
The symptoms below indicate that your wound is not healing correctly or might have an infection. They are foul odor, swelling, redness, fever, thick and discolored discharge, pain that does not improve, drainage from the wound, blue or dark color around the wound’s edges, or red streaks or blotches spreading from the wound. Therefore if you develop any of the above symptoms, you must seek medical attention immediately.
What happens during wound care?
Generally, chronic wounds usually require intensive treatment that starts with a thorough initial assessment. The health care specialist begins by reviewing your medical history, carrying out a physical exam, and evaluating the depth and size of your wound. Diagnostic tests are also performed to help identify the underlying cause of your wound. It also looks for the existence of potential complications like bone infections. Additional studies performed are vascular studies, ultrasound, blood tests, diagnostic imaging tests like CT scan, MRI or x-ray, and trans-cutaneous oxygen testing.
Which treatment might you receive for wound care?
In most cases, advanced therapies are used to promote wound healing and stabilize your wound. Some essential therapies offered are wound debridement, compression therapy, infection management, negative pressure wound therapy, bio-engineered skin grafts, pressure off-loading, and hyperbaric oxygen therapy.
Non-healing wounds and slow healing wounds can expose you to infections of the surrounding tissues and bone. Therefore if you have any of the conditions mentioned earlier and require professional wound care, call or visit Wound Evaluation-Wound Care and Hyperbaric Medicine today and get started by booking your appointment online.


Faced with the current state of affairs in the world, many people are struggling with anxiety and stress. The good news is that there is help available in the form of counselling services provided by OurOnlineTherapy. Based in Edmonton, Alberta, this counselling service offers a range of therapeutic solutions to help people manage their anxiety and stress.
OurOnlineTherapy.com offers a variety of services to help individuals cope with the mental and emotional effects of stress and anxiety. Their team of experienced psychotherapists and counsellors provide individual counselling, cognitive-behavioural therapy, and group therapy. They also offer couples and family therapy to help strengthen family relationships and work through any difficulties caused by anxiety or stress.
The counselling services offered by OurOnlineTherapy are tailored to the individual, taking into consideration their unique circumstances and needs. They take the time to understand each person’s goals and develop a plan to help them reach those goals. They also provide insurance coverage for counselling services, making it easier for people to access the help they need.
OurOnlineTherapy also offers online counselling, allowing individuals to access counselling services without having to leave the comfort of their own home. This type of counselling is particularly useful for those who may not be able to access traditional in-person counselling for various reasons, such as physical health concerns or lack of transportation. Online counselling also helps reduce the stigma associated with mental health and makes it easier to access help from the privacy of one’s own home.
OurOnlineTherapy provides a safe and confidential space for individuals to work through their anxiety and stress in a therapeutic setting. They offer a non-judgemental, understanding, and supportive environment that helps to reduce the effects of anxiety and stress. They also provide individuals with the tools and skills they need to help manage and cope with their anxiety and stress in the long-term.
If you or someone you know is struggling with anxiety or stress, consider seeking help from OurOnlineTherapy. Their experienced team of psychotherapists and counsellors are here to help individuals work through the mental, emotional, and social effects of these issues. With their help, individuals can learn the tools and skills they need to manage and cope with their anxiety and stress in the long-term.
Contact onlinetherapy.com Today


Vital Nutrients Schisandra Extract
What Schisandra Extract is Best For
Schisandra Extract is recommended for those supporting energy, endurance, and stress.
- Regarded as an adaptogen
- Supports normal liver function
- Supports normal immune and nervous systems
How Schisandra Extract Works
Vital Nutrients supports liver protective functions due to its lignan content, helps to support liver function, and supports the immune and nervous systems.
Schisandra has been used for over 2,000 years in Chinese and Japanese medicine.
Schisandra is considered adaptogenic and supports energy, endurance, and stress response.
Schisandra Extract Serving Size
As a dietary supplement, take 1 or 2 capsules once or twice daily between meals, or as directed by a healthcare practitioner.
Schisandra Extract Ingredients
Serving size: 2 capsules
Schisandra Berry Extract 1000 mg
Other Ingredients: Vegetable Cellulose Capsule, Magnesium Citrate, Cellulose, Ascorbyl Palmitate and Silica.
Warning: If pregnant, consult your physician before taking.
Independently tested for authenticity, potency, heavy metals, solvent residue, herbicide & pesticide residue, aflatoxins, stability and bacteria, yeast and mold counts.
Schisandra Extract Side Effects
Consult your healthcare provider.
Schisandra Extract Where to Buy
Schisandra Extract product is available only from licensed healthcare professionals. Buy Schisandra Extract Online here at AcuAtlanta.net or our clinic.


Health Solutions Bio Magnetic Shoulder Support.
- Small/Medium size
- 18x 1000+ gaus magnets for deep penetration
- Magnetic waves have effective therapeutic properties
- Increase healing capabilities to injured areas by improving the blood circulation
- Made from soft durable materials which offers outstanding quality and durability
- Alternative treatment to help treat pain
- By: Health Solutions


Heat stroke risk soars
THINK it's been hot lately? It feels like a furnace out there.
Mackay is in the grips of a scorching summer with no signs of the hellish temperatures easing anytime soon.
Everyone is feeling it.
Particularly the young, the sick and the elderly.
Mackay Base Hospital has recorded numerous cases of heat stroke, many affecting outdoor workers.
Despite keeping up their fluid levels, many of these workers have still suffered headaches, nausea and vomiting
Mackay Base Hospital emergency medicine specialist Dr Dale Hanson said as temperatures increased people were advised to stay hydrated and cool.
"Heat illness occurs when the body overheats and cannot cool itself down, which can occur during hot weather," Dr Hanson said.
"The effects of overheating on the body can vary from heat rash and cramps through to heat exhaustion or heat stroke."
Dr Hanson said there were several steps that could be taken to prevent heat related illnesses.
Crucial was continually drinking plenty of fluids.
Don't wait until you are thirsty to drink, drink throughout the day, he said.
"Urine colour is a good guide to hydration.
"It should be clear to light straw-coloured, not dark or golden."
"Try to stay indoors in very hot weather, preferably in an air-conditioned building, or ensure there is good air flow with fans and open windows.
"People can also stay cool by taking cool showers or baths; soaking their feet in a basin of water."
Dr Hanson said certain groups of people were more prone to heat related illnesses.
The elderly, infants, overweight people, pregnant and breastfeeding women and people with some pre-existing health conditions were most at risk.
A Bureau of Meteorology spokeswoman said we could expect a maximum daytime temperature of 31 degrees through until Sunday.
Overnight minimums would also be relatively high, with a low of 24 degrees predicted for tonight and tomorrow night, the spokeswoman said.


We are a multi-state managed care organization that arranges for the delivery of health care services to persons eligible for Medicaid, Medicare, and other government-sponsored programs for low-income families and individuals. We conduct our business primarily through licensed health plans in the states of California, Florida, Michigan, Missouri, New Mexico, Ohio, Texas, Utah, and Washington. The health plans are locally operated by our respective wholly owned subsidiaries in those states, each of which is licensed as a health maintenance organization. Our revenues are derived primarily from premium revenues paid to our health plans by the relevant state Medicaid authority, which revenues are jointly financed by the federal and state governments. Increasingly, we also derive revenues from the federal Centers for Medicare and Medicaid Services, or CMS, in connection with our Medicare services. As of December 31, 2009, approximately 1,455,000 members were enrolled in our health plans.
The payments made to our health plans generally represent an agreed upon amount per member per month, or a “capitation” amount, which is paid regardless of whether the member utilizes any medical services in that month or whether the member utilizes medical services in excess of the capitation amount. Each of our health plans is thus financially “at risk” for the medical care of its members. Each health plan contracts with health care providers in the relevant communities or states in which it operates, including primary care physicians, specialist physicians, physician groups, hospitals, and other medical care providers. These health care providers then provide medical care to the health plan’s enrolled members. Various core administrative functions of our health plans — primarily claims processing, information systems, and finance — are centralized at our corporate parent in Long Beach, California. Our California health plan also operates 17 of its own primary care community clinics; we have a Virginia subsidiary which manages three county-owned primary care community clinics in Fairfax County, Virginia; and our Washington health plan recently began operating its own behavioral health clinic.
Dr. C. David Molina founded our Company in 1980 under the name “Molina Medical Centers” as a provider organization serving the Medicaid population in Southern California through a network of primary care clinics. Since then, we have increased our membership through the start-up development of new health plan operations, the acquisition of existing health plans, and internal or organic growth. Key milestones in our history have included the following:
On January 18, 2010, we entered into a definitive agreement to acquire the Health Information Management, or HIM, business of Unisys Corporation. The HIM business provides design, development, implementation, and business process outsourcing solutions to state governments for their Medicaid Management Information Systems, or MMIS. MMIS is a core tool used to support the administration of state Medicaid and other health care entitlement programs. The HIM business currently holds MMIS contracts with the states of Idaho, Louisiana, Maine, New Jersey, and West Virginia, as well as a contract to provide drug rebate administration services for the Florida Medicaid program. The acquisition is expected to close in the first half of 2010. We intend to operate the HIM business under the name, Molina Medicaid Solutions.
Our principal executive offices are located at 200 Oceangate, Suite 100, Long Beach, California 90802, and our telephone number is (562) 435-3666. Our website is www.molinahealthcare.com.
The Medicaid and CHIP Programs. Established in 1965, the Medicaid program is an entitlement program funded jointly by the federal and state governments and administered by the states. The Medicaid program provides health care benefits to low-income families and individuals. Each state establishes its own eligibility standards, benefit packages, payment rates, and program administration within broad federal statutory and regulatory guidelines. The most common state-administered Medicaid program is the Temporary Assistance for Needy Families program, or TANF (often pronounced “TAN-if”). TANF is the successor to the Aid to Families with Dependent Children program, or AFDC, and most enrolled members are mothers and their children. Another common state-administered Medicaid program is for the aged, blind, or disabled, or ABD Medicaid members, who do not qualify under other Medicaid coverage categories. Although state programs must meet minimum federal standards, states have significant flexibility in determining eligibility thresholds, the amount of covered services, and payment rates for providers.
In addition, the Children’s Health Insurance Program, known widely by the acronym CHIP, is a joint federal and state matching program that provides health care coverage to children whose families earn too much to qualify for Medicaid coverage, but not enough to afford commercial health insurance. States have the option of administering CHIP through their Medicaid programs.
The federal government pays a portion of the costs that states incur to provide services to Medicaid enrollees. The proportion of states’ costs that the federal government pays is based on the “federal medical assistance percentage,” or FMAP. The percentage for each state is determined through a formula that assigns a higher federal reimbursement rate to states that have lower income per capita (and vice versa) relative to the national average. Prior to the implementation of the American Recovery and Reinvestment Act of 2009, or ARRA, the average matching rate that the federal government paid was 57 percent nationwide; states contributed the remaining 43 percent. The federal matching rates have both a floor (50 percent) and a ceiling (83 percent). The matching rates for CHIP are approximately one-third higher than those under Medicaid. Generally, states have more programmatic flexibility in CHIP than in Medicaid.
As part of ARRA, enacted on February 17, 2009, states were scheduled to receive approximately $87 billion in assistance for their Medicaid programs through a temporary increase in the FMAP match rate. The funding is effective from October 1, 2008 to December 31, 2010. Under ARRA, every state has received a minimum FMAP increase of 6.2 percent. The balance of funding is based on unemployment rates in the states. In order to receive this additional FMAP increase, states may not reduce Medicaid eligibility levels below the eligibility levels that were in place on July 1, 2008. Medicaid is classified as an entitlement, and therefore there is no limit on the federal funds that may be expended. Federal payments for Medicaid are limited only by the amount states are willing and able to spend. Nevertheless, budgetary constraints at both the federal and state levels may limit the benefits paid and the number of members served by Medicaid. CHIP, however, is a capped allotment. Pursuant to the Children’s Health Insurance Program Reauthorization Act of 2009 enacted on February 4, 2009, CHIP was reauthorized and expanded to cover up to a total of 11 million children by 2011. The legislation also provided an additional $32.8 billion in funding over the next four-and-a-half years, and allows states to expand coverage up to 300 percent of the federal poverty level. CHIP will continue to be funded at an enhanced match, with a minimum federal amount of 65 percent.
On March 10, 2010, the United States Senate approved legislation which would allocate $25 billion to the extension by six months of the 6.2% increase in the FMAP provided under ARRA. If this legislation is passed by the House and signed into law by President Obama, the increased FMAP paid to the states will continue through June 30, 2011.
Medicaid Managed Care. Under traditional fee-for-service Medicaid programs, health care services are made available to beneficiaries in an uncoordinated manner. These beneficiaries typically have minimal access to preventive care such as immunizations, and access to primary care physicians is limited. As a consequence, treatment is often postponed until medical conditions become more severe, leading to higher utilization of costly emergency room services. In addition, because providers are paid on a fee-for-service basis where additional services rendered result in additional revenues, they lack incentives to monitor utilization and control costs.
In an effort to improve quality and provide more uniform and more cost-effective care, many states have implemented Medicaid managed care programs. Such programs seek to improve access to coordinated health care services, including preventive care, and to control health care costs. Under Medicaid managed care programs, a health plan receives capitation payments for the covered health care services. The health plan, in turn, arranges for the provision of the covered health care services by contracting with a network of providers, including both physicians and hospitals, who agree to provide the covered services to the health plan’s members. The health plan also monitors quality of care and implements preventive programs, thereby striving to improve access to care while more effectively controlling costs.


Antioxidants scavenge free radicals and reactive oxygen species (ROS), preventing aging, disease and more. And for this reason, food and beverages (such as fruits and vegetables), supplements and even beauty products with antioxidants are so sought after. A new study supported by a grant from Dole Food Co., published in the Journal of Nutrition, wanted to establish an assay to assess the antioxidant response elements (ARE) activation capacity of fruit and vegetable extracts and determine whether such capacity was predicted by total phenolic compound (TP) content and/or ORAC activity (July 29, 2015).
As IFT explained: “To study the impact of plant-based antioxidant phytochemicals on AREs, the researchers developed an assay using IMR-32 neuroblastoma cells. The DNI laboratory prepared 134 fruit and vegetable extracts using both the flesh and peel.
“When the extracts were exposed to the assay, 107 of them activated the AREs. Some of the most effective activators included avocado peel, carrot, red pear peel, pineapple, lemon flesh, green pear peel, red delicious apple peel, spinach and a variety of lettuces. The assay results more effectively determined antioxidant capacity than the commonly used measures of TP and ORAC."
The researchers concluded: “The ARE reporter assay identified many active fruit and vegetable extracts in human IMR-32 cells. There are components of fruits and vegetables that activate the ARE but are not phenolic compounds and are low in ORAC. The ARE-luciferase reporter assay is likely a better predictor of the antioxidant benefits of fruits and vegetables than TP or ORAC."
More studies are underway to create more definitive results.


How to Choose a Detox Center in West Palm Beach
There are a number of different options out there when it comes to choosing a drug and alcohol detox center in West Palm Beach. With so many options available in regards to such an important matter, it can be confusing to know which detox program is right for you. Here is a step-by-step guide to help you learn about your detox options, find a program that is covered by your insurance, and pick a detox center that meets your unique needs.
Learn About Your Detox Options in West Palm Beach
Before you contact your insurance company or begin calling detox centers near you, you can research your different options. This can help you narrow down your options and eliminate any detox centers that are not right for you.
Inpatient vs Outpatient Detox
Detox can happen on an inpatient or outpatient basis. Inpatient means you are required to stay at the medical facility around the clock. During outpatient detox, however, you only come to the detox facility for your daily check-in and medications. Generally, inpatient detox is recommended because it is the safest way to detox. But, some individuals may qualify for outpatient detoxes, such as those with mild addictions or who are low-risk for withdrawal complications.
A qualified addiction professional can help you decide whether inpatient or outpatient detox is right for you.
Drug and alcohol detox centers in West Palm Beach may utilize different drug and alcohol treatment medications to help patients through withdrawal. The type of substance you are addicted to and your symptoms determine which medications may be prescribed to you. Medications can help reduce the severity of your withdrawal symptoms and cravings while minimizing the risk of complications.
If you know you will need a certain medication during detox, be sure you choose a center that uses that medication. For instance, some detox centers use Suboxone and Methadone, while others do not. It’s important that you choose a facility that meets your individual needs.
Find a West Palm Beach Detox Center that is In-Network With Your Insurance
Even though drug and alcohol withdrawal only lasts a week or two at most, medical detox centers can be expensive due to the intensive medical services they provide. The most affordable way to pay for detox is to find a detox center that is in-network with your insurance.
All health insurance companies in the United States are required to provide coverage for substance abuse treatment, including drug and alcohol detox. By choosing a detox center that is in-network with your provider, you can minimize your out-of-pocket costs.
Evaluate The Detox Center
Once you’ve decided the type of detox center you’d like to attend and narrowed down your options based on which ones are most affordable, you’ll want to evaluate the different services and amenities offered at the detox center. If you are unsure of which detox center to choose, your answer may lie in the details.
Some detox centers offer the bare minimum. They begin with an evaluation, take you to your room, and monitor you while providing medical support as you detox. Others offer more comprehensive services on top of medical care, such as group or individual therapy sessions. On the other hand, different facilities may have different specialties. Some detox centers specialize in treating alcohol use disorders while others have a focus on opiate addiction.
Consider your personal needs and the services offered by the detox center to make the decision that is best for you.
Amenities are extra services offered by detox and rehab centers that are not necessary for the recovery process. Instead, they are complementary. Some amenities you may find at drug and alcohol detox centers in West Palm Beach include pools, recreation areas, a gym, nutritional assistance, and massage or acupuncture. Amenities can make you feel more comfortable and relaxed as you go through this difficult part of your recovery.
Addiction recovery is an ongoing process that does not end with detox. The best detox centers will connect you with a substance abuse counselor who can help you figure out what your next steps should be. After detox, you may go to inpatient or outpatient rehab, join a 12-Step fellowship, or begin individual counseling sessions. Before choosing a detox center, make sure they can provide you with long-term care, whether it be their own rehab center or a referral program.
Find a Drug and Alcohol Detox Center in West Palm Beach Today
Here at Mandala Healing Center, our evidence-based drug and alcohol detox program in West Palm Beach combines holistic healing methods with medication management to help support you through every step of the healing process. We treat your mind, body, and spirit so you can successfully begin your recovery journey. For help with drug and alcohol addiction, contact us today.


Motivating Myself to Stick to My ‘Prophy’ Routine
Needle. Vein. My eyes shift back and forth. Needle. Vein. Which vein is large enough to hit without blowing, but small enough to anchor well? Tourniquet, needle, vein, syringe. I hate infusing. I HATE this. Well, tonight I definitely hate this.
Maybe I haven’t eaten enough, or perhaps it’s due to sleep loss over the past few weeks. I don’t have it in me, yet I am already two days late. I have to get this needle in my vein tonight. It is imperative that I push through and infuse, for my health and safety.
What is ‘prophy’?
I infuse factor VIII, a protein my blood is missing, every 72 hours. This helps to prevent bleeding episodes. Skipping doses means heightened susceptibility to bleeds. Knees, knuckles, shoulders, and ankles are often the joints I have issues with.
When people with bleeding disorders infuse clotting factors to prevent bleeds, it is called “prophylaxis,” or “prophy” for short. If people with bleeding disorders only treat when they have an active bleed, it is called “on-demand.” If someone is struggling with repeated bleeding episodes, staff at their hemophilia treatment center may suggest prophy.
I once knew a woman who was told she “wanted to be like the boys” when she fought for prophy to prevent bleeding. While she did indeed want to have access to the same treatment a man with the same factor levels would have, she did not enjoy the actual process of infusing factor. Most of us do not enjoy it.
I love that I have access to factor replacement to protect me. After a few years of working through the right product and dose, I have reduced my bleeds from every 3-6 weeks to no bleeds in about six months. This was a huge game changer for me and increased my quality of life.
Yet, I do struggle to keep up. There are days when I just don’t want to infuse. Some days I let it go, telling myself that I can have a break and infuse tomorrow. Most days, I push through and find a way so I am protected.
Why is it a struggle?
There are so many reasons people do not infuse or skip doses, including:
- Fatigue — my number one excuse.
- Memory issues — yep, they just forget.
- Embarrassment — stepping away from a group of friends or infusing in front of one can be challenging.
- Not enough time — when I am late I hate to infuse, as the stress of rushing can make me blow veins.
- Fear of needles — you would think hemophilia would cure people of needle phobias, but it doesn’t always; fear of needles can definitely impact treatment adherence.
- Lack of access — perhaps insurance is an issue.
For some, access to new treatments such as Hemlibra (emicizumab) and gene therapy has improved adherence. Hemlibra is a subcutaneous injection that may be timed as monthly, weekly, or biweekly. The time it takes to infuse is shorter, and subcutaneous administration means no more hunting for those veins! This has been a gift to our community.
Gene therapy is also an emerging treatment, which is further along for hemophilia B than A. This is seen as a “cure,” and the goal is to get the body to produce clotting factor on its own.
How I persevere
Persevering is not always easy. When I can barely keep my eyes open, infusion is overwhelming. Yet, I remind myself how fortunate I am. I have an accurate diagnosis and access to medication. I have a treatment team whose members are supportive and work to keep me healthy. Following the treatment plan reduces bleeding episodes and greatly improves my quality of life. Infusing is a win.
Giving myself the space to struggle with the act of infusion is important. It is OK to acknowledge those moments when I feel I have hit a wall. It is also OK to hate poking myself with a needle multiple times a week.
Gratitude for the ability to infuse can also help me climb out of those spaces of resistance. I am fortunate. People around the world struggle to obtain a diagnosis and factor products. I have both. I am lucky to be able to use them, even if it means poking a needle in my vein every three days. It is a win.
Note: Hemophilia News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Hemophilia News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to hemophilia.


Anil H. Vaidya, Senior Director, Scientific and Regulatory Writing/Communications. Anil has over 18 years of experience in the pharmaceutical industry, including positions as a scientist and discovery leader on the compound development team in central nervous system drug discovery research and development at Johnson and Johnson. In these roles, Anil was responsible for advancing 5 new molecular entities from discovery into early development, including one for anxiety/depression from conception to Phase 2 clinical trials. In subsequent roles as a medical writer in vaccines at Sanofi Pasteur and as an associate director in rare disease and vaccines at Pfizer, Anil supported medical writing activities for a Phase 3 clostridium difficile vaccine trial and for biologicals license applications in rare disease programs. Anil is a named author on approximately 40 publications and an inventor on a patent for the treatment of alcohol abuse, addiction, and dependency. Anil has a B.A. in Psychology with a focus in behavioral neuroscience from Rutgers University, New Jersey.


Studying of cytologic preparations of bone marrow doesn’t yield decisive results for diagnosis of hypoplastic anemia. Even at considerable devastation of bone marrow the needle can get to the center of the remained myelogenesis. It creates wrong idea of sufficient blood formation. At suspicion on bone marrow hypoplasia in connection with panhematopenia in peripheral blood it is necessary to apply core biopsy. This method gives an idea of replacement extent of bone marrow with fatty tissue. In cytologic preparations of marrow at hypoplastic anemia it is possible to reveal some features.
At attentive examination and calculation maturation violation of all three its sprouts attracts attention. A neutrophilous row comes to the end with myelocytes. Absence of the oxyphyle and the small number of polychromatophilous normocytes explains the acute anemia revealed at calculation of peripheral blood. The quantity of megalokaryocytes in a myelogram is considerably reduced. Represented megalokaryocytes has basophilous cytoplasm without platelets release. Panhematopenia in peripheral blood pointing to hypoplastic anemia was confirmed by studying of marrow. Anemia may be treated together with Canadian HealthCare Mall, a pharmaceutical company carrying out its activity in the Internet. The main goals of this web drug store is to provide people with medical preparations and outstanding service.
Sternal puncture differs because of very poor structure which can create idea of an unsuccessful puncture. However there are symptoms excluding similar suspicion. For the devastated marrow presence only of single cellular elements of marrowy blood formation among which macrophages meet, plasmatic cells are characteristic, supportive cell are possible to be observed. In this case at very poor cellular structure puncture of marrow externally was bloody and fatty, consisted of single normocytes, seldom eosinophiles. Single macrophages, plasmatic cells, the rare cellular formations extended and reminding fibroblast – elements of stroma of marrow and ugly lymphoid cells were the certificate of successful breast puncture.
However it is necessary to remember that hit of needle in the center of safe blood formation can create false representation. The results should be truly confirmed and after the diagnosis establishment you may order drugs via http://thecanadianhealthcaremall.com/ Canadian HealthCare Mall. You may find everything you need in one place, remember this fact!
Category: Canadian HealthCare Mall
Tags: blood formation, hypoplastic anemia, neutrophilous, normocytes


medical Definition of acinetobacter
- A hospital outbreak involving multidrug-resistant Acinetobacter strains … should prompt an infection control investigation of compliance with hand washing, barrier precautions, ventilator care, and housekeeping.
- —The Merck Manual of Diagnosis and Therapy, 18th edition, 2006
- Although acinetobacters are frequently isolated from several areas of the human body, there is some uncertainty as to whether they are present as contaminants rather than as commensals.
- —Elliot June, in Bergey's Manual of Systematic Bacteriology, 2005


Save Big Money on your Dental Implant Supported Bridge Treatment in India..
Price from 350 USD $ ( onwards * ) per implant …
Get Single Tooth Implant in just 1 to 2 days in India..
With High class world renowned dental Implants..
Dr. Goswami’s — Delhi Dental Center in India offers best price low cost of high quality immediate tooth Dental Implant dental bridge treatment procedures.
A True savings of almost 70 % to 80 % in cost in normal to complex procedures as compared to cost of dental implant treatment price in Bangkok Thailand Budapest Hungry America Europe Canada Australia and other parts of the world.
The total cost of tooth Dental Implant supported Dental Bridge treatment procedure with all new set of teeth at Delhi Dental Center in New Delhi, will be around 55 to 65 % less than what a person will pay in Europe, Australia, Thailand, Canada or America.


Several recent media reports underscore the important-and growing-role of pharmacists as health care resources.
Several recent media reports underscore the important—and growing—role of pharmacists as a health care resource.
Whether they are looking for health advice or vaccines, patients can turn to their pharmacist to fill their health care needs, as 2 news reports cited in a recent press release from the National Association of Chain Drug Stores demonstrate.
An article published on July 22, 2012, in the Delmarva Daily Times highlighted the role of pharmacists in medication management, including educating patients regarding possible side effects, contraindications, and allergic reactions. The article stressed the importance of pharmacists’ interactions with patients and their families.
“We can help patients better understand their medications,” Cynthia Boyle, PharmD, of the University of Maryland Eastern Shore’s School of Pharmacy, told the newspaper. “In fact, a significant part of our curriculum is teaching students to meet the needs of patients and families through health promotion and education.”
Meanwhile, an article published on July 23, 2012, in the South Florida Sun Sentinel reported that Florida pharmacists can now administer the shingles and pneumonia vaccines. Pharmacists, who previously had only been allowed to give influenza vaccines, gained the new powers under the state’s Vaccine Access Act., which went into effect on July 1.
“It’s more convenient than waiting in the doctor’s office,” Ray Sternberger, a Fort Lauderdale resident, told the paper. “It makes a lot of sense.”
Pharmacy advocates in the state noted that the law acknowledges the pharmacist’s role as a health care resource and encourages improved public health and awareness, according to the article.
“Pharmacists are among the most accessible health care professionals in the community today,” Valerie Wickboldt, of the Pharmacy Choice and Access Now Coalition, told the paper. “People use their pharmacy an average of once a month, so pharmacies can advertise the importance of these immunizations more readily to a broader population.”
According to the Centers for Disease Control and Prevention, the portion of flu shots administered by pharmacists increased from 7% in the 2006-2007 influenza season, when pharmacists were first allowed to administer the shots, to 18.4% in the 2011-2012 season.
“Any time you have an opportunity to help someone from being sick or help someone stay healthy, and to prevent the increased costs of health care in this state, it’s gotta be a win for everybody,” Michael Jackson, vice president of the Florida Pharmacy Association, told the paper.