Friday, July 31, 2009

Alabama sports medicine doctor Larry Lemak branching practice into Shelby County

Dr. Larry Lemak is expanding his sports medicine business into Shelby County with a new $1.5 million facility next to Shelby Baptist Medical Center.

Lemak Sports Medicine-Shelby, which will be built in a former SouthTrust Bank branch next to the Alabaster hospital, represents the first clinic the noted orthopedic surgeon has opened outside of his central practice at Brookwood Medical Center.

"We're happy to be in Shelby County and growing our practice to make care more accessible for our patients and the citizens of Shelby County," Lemak said in a statement about the project.

The building has been empty for more than four years. Lemak Sports Medicine aims to occupy the building by the end of this year after renovations are completed. The building will have 4,000 square feet of physician office space and 2,500 square feet for outpatient services.

The office will be led by Dr. Mike Patterson, a physician from Tuscaloosa. The practice will focus on sports medicine and outpatient physical therapy. Patterson, a former Florida State University defensive back, will also have access to Shelby Baptist Medical Center for other procedures.

Alabaster MB LLC, a partnership between Lemak and his son Matthew, owns the building. Matthew Lemak's company, the Lemak Group, is a development partner along with Jonathan Lindsey of Southpace Properties Inc., who also brokered the purchase of the building. Jim Strickland of RealtySouth represented the seller of the building.

Matthew Lemak said the practice not only looks to serve Shelby County, but also Chilton County. Patterson already has started lining up high schools to work with for the upcoming football season.

Lemak Sports Medicine provides medical assistance to many high schools and colleges around the state.

Matthew Lemak said the Shelby County practice may add another physician in a year or two if the market demands it.

Meanwhile, the Lemak Group is scouting other parts of the metro area to expand Lemak Sports Medicine. Matthew Lemak said the northern part of the metro area will likely be the next destination for the practice.

The new office comes a year after Dr. Lemak set up his own practice at Brookwood following a split from long-time partner Dr. Jim Andrews. The two men created the Alabama Sports Medicine & Orthopaedic Center that lasted more than two decades and built an international following.

Why Do We Spend $34 Billion in Alternative Medicine?

Chances are that one out of every three people you see in the grocery store, on the street or at work have tried alternative medicine, and they're spending quite a bit for it.

he National Institutes of Health (NIH) announced Thursday that Americans spent $34 billion on complementary and alternative medicine in 2007. The study queried more than 70,000 people across the country about 36 various forms of alternative treatments.

But researchers say they still don't know exactly why people are turning to these therapies.

"Since this was a point of time survey, we weren't necessarily asking people about why or how they made their decision," said Richard Nahin, an author of the study released by the NIH and the National Center for Complementary and Alternative Medicine (NCCAM).

The $34 billion spent on complementary and alternative medicine pales in comparison to the $2.2 trillion spent on health care annually, but alternative therapies accounted for up to 10 percent of out-of-pocket health costs.

Yet, at the same time as Americans are embracing alternative medicine, the American Medical Association's (AMA) policy on the matter far from endorses the treatments.

Wednesday, July 29, 2009

Royal Pharmaceutical Society Calls for Older People to Review Their Medicine With a Pharmacist

New research released today by the Royal Pharmaceutical Society of Great Britain (RPSGB) reveals how older people are taking a cocktail of medicine without fully understanding what they are or the side effects they are causing.

The RPSGB survey shows that nearly half (43%) of over 65's are currently taking over five medicines at any one time. However, one in five admits to not always taking the medicine as prescribed. Sixty per cent also believe that they either definitely or possibly have had a side effect from medicine - yet one if five said they did not get it checked out.

In response to these findings, the RPSGB is launching a campaign to urge older people to review the medicine they are taking by visiting their local pharmacist for a Medicine Use Review (MUR).

MURs are undertaken by local pharmacies to help patients manage their medicine more effectively and can be done on an annual basis. It involves a consultation with a pharmacist and can be offered to anyone on one or more medicines and/ or long term conditions.

Royal Pharmaceutical Society spokesman and pharmacist, Paul Johnson says; "It's not unusual for older people to get confused with the medicine they are taking, particularly when they are on numerous types of medication. As a result, they may also not realise the reactions they may be causing when they are not used properly.

"Pharmacists are easily accessible and are ideally placed to provide advice to a patient on their medicine which can really improve someone's health or even their quality of life. "

Other findings of the research revealed that almost one in 10 (9%) admit to not fully understanding what their medications do or how they treat their condition, and one in seven (14%) say they sometimes forget to take a pill at the recommended time.

Notes to Editor

Royal Pharmaceutical Society of Great Britain

The Royal Pharmaceutical Society of Great Britain (RPSGB) is the professional and regulatory body for pharmacists in England, Scotland and Wales. It also regulates pharmacy technicians on a voluntary basis, which will become statutory from 1 July 2009. The primary objectives of the RPSGB are to lead, regulate, develop and represent the profession of pharmacy.

The RPSGB leads and supports the development of the profession within the context of the public benefit. This includes the advancement of science, practice, education and knowledge in pharmacy. In addition, it promotes the profession's policies and views to a range of external stakeholders in a number of different forums.

Following the publication in 2007 of the Government White Paper Trust, Assurance and Safety - The Regulation of Health Professionals in the 21st Century, the RPSGB is working towards the demerger of its regulatory and professional roles. This will see the establishment of a new General Pharmaceutical Council and a new professional body for pharmacy in 2010.

The YouGov survey was undertaken by the Royal Pharmaceutical Society between July 20 and 22 and had a sample size of 2,145 Great Britain Adults.

U.S. Begins Human Testing of H1N1 Vaccines

Early next month, the U.S. will begin its first human trials of new vaccines against the H1N1 (swine flu) virus. In addition to evaluating safety and effectiveness, researchers are seeking to determine the proper dosage.

Dosage is a particular concern with H1N1 because the last major swine flu outbreak in the U.S. occurred in 1976 -- meaning an entire generation has grown up with no exposure to the disease.

"When a population has not seen a virus, the question becomes: If you give them a vaccine, is one dose enough?" said Sri Edupuganti, MD, an infectious disease physician with the Emory University School of Medicine.

Dr. Edupuganti serves on the staff of Emory's Hope Clinic, one of eight sites around the country selected to test H1N1 vaccines. She and other vaccination experts say it's likely Americans will require two separate shots to build up full immunity to the swine flu virus.

Because H1N1 differs from seasonal flu, medical experts say it's unlikely vaccines for each virus will offer any crossover protection. So, don't be surprised if you need three shots this fall.

Alternative medicine could be part of health care reform

If Senator Tom Harkin (Dem-Iowa) has his way, the new health care reform bill will provide coverage for alternative medicine practices, such as acupuncture, massage therapy, yoga, naturopathy, and herbal remedies. The measure cosponsored by Harkin would prohibit health insurance companies from discriminating against health care providers who offer alternative medicine therapies.

Alternative medicine methods are popular in the United States. According to the National Center for Complementary and Alternative Medicine, which Senator Harkin was instrumental in creating, 38 percent of adults use at least one form of alternative medicine. Among children age 17 years and younger, usage is 12 percent.

The most commonly used alternative medicine practices used by adults in the United States include nonvitamin, nonmineral natural supplements (17.7%; most common include fish oil or omega-3 fatty acids, glucosamine, Echinacea, flaxseed, ginseng); deep breathing exercises (12.7%), meditation (9.4%), chiropractic or osteopathic manipulation (8.6%), massage (8.3%), and yoga (6.1%). Note that supplements such as individual or multi-vitamin/minerals were not considered alternative medicine.

Many adults turn to alternative medicine for the treatment of painful conditions such as back and neck pain, joint pain or stiffness, arthritis, and other musculoskeletal problems. Other common uses include relief from colds and flu, gastrointestinal complaints, stress, and menstrual problems. Women use alternative medicine methods more than men (42.8% vs 33.5%, respectively).

Senator Harkin notes that alternative treatments are less costly than conventional approaches and can be pursued instead of drugs or medical interventions in some cases, especially the conditions for which many people already use complementary approaches. Alternative treatments have already been embraced by many top medical institutions and medical schools across the country, including Memorial Sloan-Kettering Cancer Center, University of Maryland School of Medicine/Center for Integrative Medicine, and the Rosenthal Center for Complementary and Alternative Medicine at Columbia University. More than 75 percent of medical schools in the United States include coursework in alternative medicine.

The alternative medicine amendment cosponsored by Senator Harkin has been adopted by a Senate committee. It remains to be seen whether any or all of the language in the measure makes it to the health care reform bill.

Tuesday, July 28, 2009

Swine Flu / Europe: Race against the clock to have vaccines before winter

European governments say that they are accelerating the process of approval of Swine Flu vaccine, what has experts somewhat worried.

The European Agency of Medicine, the principal regulatory organ in the European Union,took the fast track for the approval of the vaccine. Countries such as Great Britain, Greece, France and Sweden said that they will begin to apply it as soon as it is approved, possibly in some weeks.

In Europe, generally, vaccines are tested in hundreds of persons for weeks or months, to make sure that the immune system should generate the sufficient amount of antibodies to attack the infection.

But the determination for achieving a vaccine as soon as possible, the agency is allowing companies to jump the tests with big individuals quantities.
Doctor Keiji Fukuda, chief of the flu department of the World Health Organization, warned about potential dangers that vaccines represent when they are not tested in the laboratory, although he did not criticized the European position.

European officials do not know if the vaccine is going to have unexpected side effects until million persons have been vaccinated. Nevertheless, they think that the risk is worth while for the lives that will be saved.

The main difficulty is that, probably, without large-scale tests, will be the difficulty in getting a suitable dose, this can cause Europeans to obtain a very weak version of the vaccine.

It is slightly probable that the vaccine is dangerous, but nobody will have this certainty until many people prove it.
Neither the manufacturers the European agency wanted to give details on the basic safety experiments they run.

More Americans choosing complementary or alternative medicines

Complementary and alternative medicine - CAM - covers many different practices and products that fall into four main categories:

1) Alternative medical systems such as homeopathic medicine, naturopathic medicine and traditional Chinese medicine.

2) Mind-body interventions such as meditation, prayer, biofeedback and hypnosis.

3) Biologically based therapies such as herbs, supplements and aromatherapy.

4) Manipulative and body-based methods such as acupuncture and chiropractic care.

One of the best places to learn about the effectiveness and safety of CAM therapies and products is the National Center for Complementary and Alternative Medicine. The site, part of the National Institutes of Health, contains a wealth of research-based information on everything from acupuncture, an ancient Chinese healing practice, to St. John's Wort, an herb used to treat depression and anxiety.

Kaufmann said there's a common misperception that all herbal medications are safe. "Herbs are quite often potent pharmaceuticals," she said. Many of them have side effects and risks just like prescription drugs. Peppermint oil, for example, is often taken to relieve abdominal cramps, she said. But a side effect of peppermint is acid reflux, she said.

"People should tell their physician and their pharmacist about any complementary treatments they are using," she said.

Interest is growing in CAM because many people have become disillusioned with the way traditional medicine is practiced, said Dr. Scott Treatman, director of employee health services at Crouse Hospital. He teaches mindful living and stress reduction through SUNY Upstate Medical University and provides acupuncture.

"There's been a bad taste in peoples' mouths when they saw Vioxx and other medications pulled off the market," Treatman said. "Acupuncture has been around 3,000 years and it hasn't been recalled."

Crouse is becoming a leader in what Treatman calls "integrative medicine." Integrative medicine combines treatments from conventional medicine and CAM for which there is evidence of safety and effectiveness.

He said mainstream medicine has become much more accepting of alternative approaches, especially those aimed at reducing stress.

"When you think of all the common diseases we have like migraines, irritable bowel syndrome and high blood pressure, stress is what's making us sick," he said.

Kaufmann teaches mindfulness and meditation to help people with weight problems.

"I kept seeing patients whose major problem could not be helped with traditional medical treatment," she said. "Much disease is caused by behavioral problems like overeating."

Most people pay for CAM out of pocket because health insurance often does not cover these treatments and products. CAM therapies most likely to be covered by insurance include chiropractic, massage therapy and biofeedback.

Monday, July 27, 2009

BioScrip expansion to offer injectable medicine

Despite a difficult economy, BioScrip, a Columbus-based pharmaceutical company, is continuing its expansion with the addition of an ambulatory infusion center.

The center, which will allow patients to receive injectable medications at the BioScrip facility rather than going to a hospital or clinic, is tentatively set to open in early 2010.

The company's growth mirrors the overall health-care industry, which has been able to avoid the worst effects of the downturn.

The expansion also includes a renovation of the company's specialty pharmacy operation, which mails out approximately 6,000 prescriptions daily nationwide. Both the center and pharmacy are in Hilliard.

The opening of the infusion center, however, also will signal BioScrip's switch to an open pharmacy, meaning patients will have the additional option of being able to go to the facility to pick up their medication.

"It helps to reduce the cost and adds convenience for patients," said Russ Corvese, executive vice president of mail operations. "Many of them need these medications on a frequent basis."

Dr. Erick Arce, a neurologist with Neurological Associations in Columbus, treats patients with multiple sclerosis and chronic headaches who use infusions. He said giving patients access to these medications outside a hospital can be convenient for those who live outside the city and have trouble getting around.

"They have the ability to be more flexible," Arce said. "But there are typically no physicians on-site, and if there are complications, the patient will probably end up at the emergency room when maybe they didn't need to be."

The mail-order operations remain BioScrip's main business. The company has grown from 40 employees to about 250 since it was created in 1994 in Rhode Island. Columbus became BioScrip's headquarters for mail-order prescriptions in 2000. It has relationships with companies whose insurance policies offer BioScrip's mail services as an option, or drug companies that make their medications available exclusively through BioScrip.

The infusion center will have specialized staff members to help with treatment and medications for diseases such as hemophilia, hepatitis C, multiple sclerosis and rheumatoid arthritis. BioScrip employs nurses and special technicians to keep in contact with these patients and check up on how their treatment is going.

Many of the injectable medicines must be mixed just before they're dispensed, Corvese said, making the care of chronic diseases difficult and burdensome, not to mention expensive. The price of medications ranges from $2,000 to $5,000.

"Some of these medications don't actually make the patient feel better" but help to manage the disease, Corvese said "We have people on hand to do side-effect management as well." Some of the medications prevent flare-ups, or an escalation to a more severe stage, he added.

For rheumatoid arthritis, many of the most effective medications are either injections or infusions, said Nicholas Turkas, director of public health for the Arthritis Foundation's central Ohio chapter.

"These kinds of medications are a quantum leap forward as far as treatment goes," Turkas said. "Anything that can increase convenience for the patients is very important."

Iris QA Announces New Nuclear Medicine (NM) Tool Kit for Nuclear Medicine Imaging Systems

IRIS QA, LLC, a leader in the development of software based analysis tools for the CT, MR and NM imaging systems, announces the launch of a new Nuclear Medicine (NM) Took Kit application which provides a simple windows based interface that supports DICOM 3.0 image data.

A single page report is generated for each analysis which contains information about the following: the site, imaging system, data acquisition parameters, test results along with a thumbnail image of the processed data.

The processing tools for the following NEMA tests are included: Intrinsic spatial resolution, Intrinsic spatial linearity, Multiple window spatial registration, System spatial resolution with scatter, System spatial resolution without scatter, SPECT reconstructed spatial resolution without scatter and SPECT reconstructed spatial resolution with scatter.

Additional SPECT analysis tools are available for the SpecphanTM QC phantom. This package can be used as a companion product with IRIS QA's CT AutoQA Lite package for providing a comprehensive analysis for CT and SPECT/CT imaging systems.

The initial release of the CT tool took place in the late 1980's as PC/AutoQA (The Iris, Inc.), which was the first automated QA program commercially available for CT.

IRIS QA'a research and development team of senior scientists are constantly working to stay at the forefront of QA/QC testing to provide medical facilities the best software and services available.

Services include Acceptance testing and annual systems testing to fulfill ACR accreditation requirement for CT, MR and NM imaging equipment as well as support to sites applying for ACR accreditation or re-accreditation by collecting the phantom data and completing the annual system report.

Sunday, July 26, 2009

Thank God for "Socialized Medicine"

I woke up at seven in the morning. I had this pain like I never had experienced before. I was away from my partner sitting, standing, and writhing in pain in Paris. I found my way to a friend, Pedro-Paolo, who managed an antiques store in the St. Germain des Pres. He directed me to Hotel-Dieu, a hospital and ER, adjacent to the Cathedral of Notre Dame.

I checked in, and, for two hours, groaned in pain on a dirty floor until I was unclothed and put on a stretcher, left unattended for two more hours next to a door (cold--it was January) where hospital staff would go out to have a smoke--tobacco or otherwise.

I was examined, reexamined, ultrasounded, CT-scanned, EKG'd, and, well, the list goes on. After eleven hours, I was told that I had a kidney stone most likely related to the fact that I had consumed "dirty" spinach and had not been adequately hydrated.

The care I received (after the first hour or so) was kind, compassionate, competent, and helpful. I recalled an ER experience at Northwestern Hospital in Chicago years before when I had a "stomach virus" and laid on a stretcher for twenty hours before I pulled out my IV to give a lecture as a visiting professor at Rush-Presbyterian Hospital.

In the Chicago experience, I received bills from countless entities totaling more than $4,000 for a stay where I was not diagnosed, left in pain and helpless, and literally left the ER with blood dripping from my arm.

"Au contraire" in Paris. I left with a clear idea what was happening, with prescriptions, with a follow-up appointment--and oh--with a bill--for 300 francs--forty-eight dollars.
Then, when I got back to our apartment and was still feeling ill, I called a friend's physician who came at 3:00 a.m. to help, comfort, and treat me. At no cost.

God bless socialized medicine. I have always said, as a physician, to the government, "Give me one billion dollars, and I will show you how to save ten trillion dollars." In my medical practice, I hired seven additional employees to help--not with our bills--but with the hundreds of other bills patients had which made sick people sicker trying to figure out how to deal with all the paperwork.

The time has come, let us have FAITH in a system where HEALING is dispensed rather than BILLS DISPERSED. This should be the SOLEMN VOW of any physician--and btw--I loved saying that to my husband when we were married one month ago in Connecticut. Some take those vows for granted; others crave to make them; don't anyone belittle those simple, solemn, and loving words.

Greenwich Sports Medicine surgeon named one of “America’s Top Doctors”

Sports Medicine Orthopedic Surgeon Jo A. Hannafin, M.D., Ph.D., of Greenwich, was named one of “America’s Top Doctors,” in the current edition of Castle Connolly’s directory of outstanding physicians in the United States. Dr. Hannafin practices at Hospital for Special Surgery’s Affiliate Physician Office located at 143 Sound Beach Avenue, Old Greenwich, Conn.

Dr. Hannafin, formerly a three-time gold medalist at the U.S. National Rowing Championships and a respected team physician, brings the expertise of personal athletic excellence to her role as orthopedic director at the Women’s Sports Medicine Center at Hospital for Special Surgery. The center is the first of its kind in the United States.

Southern Connecticut residents benefit from the following areas of her expertise: female athletes, shoulder and knee instability, ligament reconstruction and arthroscopy, rotator cuff disease and adhesive capsulitis of the shoulder.

With the reputation of Hospital for Special Surgery combined with the convenience of a southern Connecticut location, the HSS Affiliated Physician Office provides a highly sophisticated range of services in Orthopedics, Physiatry and Sports Medicine. Specialties include foot and ankle, hand/upper extremity, hip and knee, spine, pediatric and adolescent sports medicine, sports medicine and shoulder surgery, trauma and joint replacement. (Telephone number: 203-409-3000.)

About Hospital for Special Surgery

Founded in 1863, Hospital for Special Surgery (HSS) is a world leader in orthopedics, rheumatology and rehabilitation. HSS is nationally ranked No. 2 in orthopedics, No. 3 in rheumatology and No. 24 in neurology by U.S. News & World Report (2009), and has received Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center. In 2008 and 2007, HSS was a recipient of the HealthGrades Joint Replacement Excellence Award. A member of the NewYork-Presbyterian Healthcare System and an affiliate of Weill Cornell Medical College, HSS provides orthopedic and rheumatologic patient care at NewYork-Presbyterian Hospital at New York Weill Cornell Medical Center. All Hospital for Special Surgery medical staff are on the faculty of Weill Cornell Medical College. The hospital's research division is internationally recognized as a leader in the investigation of musculoskeletal and autoimmune diseases. Hospital for Special Surgery is located in New York City and online at

Saturday, July 25, 2009

Heart doctor named president of cardiovascular society

San Antonio cardiologist Steven R. Bailey has accepted a one-year term as president of the Society for Cardiovascular Angiography and Interventions, the primary professional organization for more than 4,000 invasive and interventional cardiologists.

Dr. Bailey is chief of the Janey and Dolph Briscoe Division of Cardiology at the University of Texas Health Science Center at San Antonio. He is also a professor of medicine and radiology in the School of Medicine and sees patients at UT Medicine San Antonio.

Invasive and interventional cardiologists perform a range of heart procedures, including the placement of coronary artery stents, cardiac catheterization and diagnostic angiography. Bailey teaches students, residents and fellows and conducts research on a number of topics, including the development of next-generation stents. Stents are small wire-mesh tubes that hold arteries open.

The Health Science Center is South Texas’ leading health research institution. It has six campuses in San Antonio, Laredo, Harlingen and Edinburg and trains physicians, dentists, nurses, scientists and allied health professionals.

UPDATE 1-Sanofi's Lantus drug no cause for concern -EU agency

The European Union's drug watchdog cast further doubt on recent studies suggesting a possible cancer risk with Sanofi-Aventis's (SASY.PA) widely-used Lantus diabetes drug.

The European Medicines Agency said in a statement on Thursday its experts concluded that the available data does not provide a cause for concern and changes to how the drug should be prescribed were not necessary.

It also called on the French drugmaker to generate further research on the drug.

"Due to methodological limitations the studies were found to be inconclusive and did not allow a relationship between insulin glargine and cancer to be confirmed or excluded," the agency said in a statement, referring to the drug's generic name.

"In addition, the committee noted that the results of the studies were not consistent."

"This is important and reassuring information for patients receiving Lantus," said Jean-Pierre Lehner, the group's chief medical officer, adding the review confirmed Lantus use should continue unchanged.

Sanofi said it would take steps to develop further research in the area, in line with recommendations made recently by an independent panel.

The guidance came after the U.S. Food and Drug Administration earlier this month questioned four recently published studies over the cancer link, saying they did not track patients long enough to properly evaluate any such risk from the drug.

Sanofi has firmly stood behind its long-acting insulin medicine Lantus seen as a medicine able to offset a fall in sales of other products, such as Plavix and Lovenox, which could soon face generic competition.

Its stock dived last month when worries about a possible but uncertain link with cancer first surfaced.

he drugmaker said at the time the data was of "poor quality" and no firm conclusions could be drawn. A group of independent experts invited by Sanofi to review the studies later concluded the studies were flawed.

Lantus had sales of 2.45 billion euros ($3.5 billion) in 2008 and had been expected to continue to grow strongly, reflecting the growing incidence of diabetes worldwide.

The last big safety scare over a diabetes drug involved GlaxoSmithKline's (GSK.L) pill Avandia, linked to heart attack risk in a U.S. study in 2007. Glaxo contested those findings, but sales of the drug still halved.

Sanofi shares rose after the announcement and closed up 1.2 percent at 46.31 euros. (Reporting by Michael Kahn; Addition Reporting by Helen Massy-Beresford; Editing by David Cowell and Dan Lalor) ($1 = 0.7030 euro)

Socialized medicine 
isn’t the answer

For those of you who think a government-run, single-payer health care system is the answer, you’re obviously not informed about the programs in Canada and Great Britain. They involve government making the decisions and rationing, with long waits to get treatment. The incentive for the doctors to provide good care is gone since they’re government employees. The people who get good, immediate care are the ones who have money and come to the United States. Many others die before they get treated.

Also, their systems are strapped financially, as is our government-run Medicare system, and there’s no money for research.

When has the government handled anything better than the free enterprise system?

If you think your health insurance is expensive now, wait until you see what the proposed free government system will cost you. Also, it still leaves many people without coverage.

We have a great health care system, that can obviously be much improved upon without socialism. There are many viable ideas on the table that will help.

Friday, July 24, 2009

Protein Excreted In Urine May Be Help In Diagnosing Kidney Disease Caused By HIV

New data collected at Columbia University Medical Center and by the Mount Sinai School of Medicine are helping researchers understand the extent to which a certain protein – NGAL – can play a significant role in marking chronic kidney disease resulting from HIV while at the same time distinguishing nephropathy from more common causes such as diabetes and hypertension.

It's well-known that Human Immunodeficiency Virus-associated nephropathy (HIVAN) is an important cause of kidney disease in HIV-infected patients. Antiretroviral therapy plays an important role in the treatment of HIVAN, yet despite advances in understanding HIVAN, current recommendations for treatment have largely been based on observational data and can only definitively made after a kidney biopsy.

The current study, spearheaded by Columbia University's Jonathan Barasch, M.D., Ph.D., along with Ali Gharavi M.D., Ph.D., Neal Paragas M.S., Thomas Nickolas M.D., M.S., and Vivette D'Agati M.D., together with Paul Klotman, M.D., Christina Wyatt M.D., and Susan Morgello M.D., of the Mount Sinai School of Medicine and Landino Allegri in Parma, Italy, and Prasad Devarajan in Cincinnati Childrens Hospital, represents the examination of data from human cohorts in New York and Parma, and from mouse models created by Dr. Klotman.

The team noted that NGAL, or Neutrophil Gelatinase Associated Lipocalin, a protein they previously discovered in damaged kidneys, was prominently expressed in kidney tissue and in the urine of humans and in mouse models of HIVAN. The high levels of the urine protein were out of proportion to the degree of chronic renal failure, for example that typifies patients with other types of chronic glomerular diseases of both mice and humans. Most strikingly, Paragas, Barasch, and Gharavi noticed that the rise in urinary NGAL levels was in conjunction with the development of a specific type of lesion, namely tubular cysts that typify HIVAN. The association with these cysts consequently may justify their biopsy or an aggressive treatment with antiretroviral drugs when high levels of urine NGAL are discovered.

"From what we can tell, NGAL is unexpectedly expressed in great abundance by kidney cysts allowing the clinician to potentially identify HIVAN among other types of chronic kidney diseases and hopefully to intervene to prevent a kidney from ultimately dying from what physicians refer to as ESRD, or 'end-stage renal disease,'" Dr. Barasch says.

Dr. Barasch cautions that studying a much larger human cohort would be needed in order to determine the precise relationship of NGAL to HIVAN and whether the protein is a good enough predictor of tubular cysts, but he finds the results of the study unexpected and intriguing.

The research appears in an upcoming Journal of the American Society of Nephrology and was funded in part by the Emerald Foundation, the March of Dimes, the National Institutes of Health and the Glomerular Center of Columbia University.

Not adequately diagnosing kidney problems can be life-threatening and NGAL expression which is induced in kidney disease and damage can help identify patients at risk of kidney failure even in those without HIV. Last year, Dr. Barasch and Nickolas found that approximately 65 percent of patients with NGAL protein in the urine upon presentation to the Emergency Department will require care by a nephrologist, another 32 percent will need dialysis, and 29 percent will require care in the intensive care unit, over the course of a week following the subsequent hospitalization. That study was published in the June 3, 2008, issue of the Annals of Internal Medicine.

We All Pay for Defensive Medicine

I have witnessed the explosive growth of defensive medicine during my 34 years as a primary-care physician in private practice.

Nowadays the standard of care for a visit to a cardiologist is an electrocardiogram, an echocardiogram, a nuclear stress test and a 64-slice CT coronary angiogram, all done on the practice’s own equipment so that it can capture every possible cent of the revenue. Oh, did I mention, a cursory history and physical? Meanwhile, a visit to the emergency room for any complaint requires at least one CT scan of the affected part of the body.

Are the patient outcomes any better? Not really. Are the costs much higher? Of course, by an astronomical factor.

However, I am not blameless either. Since I was sued (unsuccessfully) in 1995, I have doubled and tripled the number of tests and consultations that I order, and I haven’t been sued since then. A scalded cat won’t sit on a cold stove either.

Dennis H. Murphree, M.D.

San Antonio

Thursday, July 23, 2009

Extreme Glucose Levels In Diabetic Patients With Heart Failure Linked To Increase Risk Of Deaths

Compared with patients with moderately controlled glucose levels, diabetic patients who have heart failure and either too high or too low glucose levels may be at increased risk of death, said researchers at Baylor College of Medicine in a report published in the current issue of Journal of the American College of Cardiology.

To determine average glucose levels in the blood over a two to three month period, doctors measure glycosylated hemoglobin (the oxygen-carrying protein in the blood that is bound to the sugar glucose). In general, higher levels have been associated with increased risk of heart disease, said Dr. David Aguilar, assistant professor of medicine – cardiology at BCM.

"Most doctors try to keep glucose levels of those with diabetes as low as they can to lower the risk of complications such as eye problems, kidney disease or the development of heart disease," said Aguilar, senior author of the study. "However, we found that in diabetic patients with heart failure, glucose levels slightly higher than what are normally recommended had the lowest risk of death."

Researchers at BCM and the Michael E. DeBakey Veterans Affairs Medical Center in Houston identified 5,815 veterans with heart failure and diabetes who were receiving treatment at VA medical centers across the nation. They followed the patients for two years, dividing them into five categories based on their glycosylated hemoglobin levels.

Most medical professionals recommend levels at 7 and below as the target for optimal health for diabetic patients. However, the results of the study of diabetic patients with heart failure showed that those with levels 7.1 to 7.8 had the lowest rate of death. Those patients at both ends of the spectrum had the higher death risks.

"This doesn't mean that diabetic patients with heart failure should change their target goal for glucose levels," Aguilar said. "The results could simply be telling us that the glycosylated hemoglobin levels are a marker for other risks that are contributing to increased risk of death, but not necessarily the cause of the problem."

Aguilar said the correlation needs to be further investigated to confirm the findings and see what other factors could be contributing to the mortality rate.

The research is supported by a V.A. Health Services Research and Development Service grants and a National Institutes of Health Mentored Career Development Award.

Other researchers who took part in this study include, Drs. Biykem Bozkurt, Kumudha Ramasubbu and Anita Deswal, all from the Winters Center for Heart Failure Research and Section of Cardiology, and the Department of Medicine at BCM. Deswal is also at the Houston Center for Quality of Care and Utilization Studies at the Michael E. DeBakey V. A. Medical Center in Houston.

Atlanta Sports Medicine Doctor Spero Karas Wins 'Atlanta's Top Doctors' Honor Again

Spero G. Karas M.D. has again been profiled in Atlanta Magazine's Top Doctors issue within the Orthopedic Surgery category. One of only five Orthopedic Surgeons listed in the July 2009 exclusive, Dr. Karas retains this distinction from the magazine's previous Top Doctors list compiled in July 2007.

Atlanta Magazine compiles its biennial list of "Atlanta's most trusted physicians" based on the results of the highly-regarded Castle Connolly Top Doctors survey. Castle Connolly's physician-led research team follows a rigorous screening process in which board-certified physicians and medical leaders identify particular doctors they feel best embody the ideal of excellence in patient care.

In essence, Dr. Karas and others selected for the Top Doctors list represent those to whom the nominating physicians would send their own families. It is important to note that doctors do not and cannot pay to be profiled as Castle Connolly Top Doctors. Selections are entirely peer-based and randomly sampled. Hence, the results of the vigorous screening process truly identify the most respected doctors in America, subdivided by fields of practice and geographical region.

Dr. Karas was specifically cited for his special expertise in elbow reconstruction, knee reconstruction, shoulder reconstruction, and sports medicine in the Atlanta metro area.

In addition to having been distinguished twice by Atlanta Magazine for being the city's "Most Trusted Sports Medicine Specialist," Dr. Karas was recently included in Castle Connolly's "Best Orthopedic Surgeons in America" list. He was featured last year in Women's Health Magazine's "America's Top Doctors for Women" and Men's Health Magazine's "Top Sports Medicine Specialists."

Dr. Karas specializes in providing comprehensive care to people of all ages with shoulder pain, knee pain, and upper extremity conditions related to traumatic, degenerative, sports and work-related injuries.

As Director of Emory University's Orthopaedic Sports Medicine Fellowship Program, Dr. Karas is a recognized expert in the field of shoulder surgery, knee surgery, arthroscopy, and sports medicine. He has been inducted into the prestigious American Shoulder and Elbow Society, one of only five other physician members in the state of Georgia. In addition to Dr. Karas' role as director of Emory Orthopaedic Sports Medicine, he currently serves as a consulting team physician for Georgia Tech University, Emory University Athletics, and Lakeside High School.

For more information about Dr. Spero Karas or the Emory Sports Medicine Center, contact Dawn Ulloa or visit

About Emory Sports Medicine Center:
The Emory Sports Medicine Center is a global leader in providing advanced treatments for patients with sports and orthopaedic injuries. Patients treated there range from professional athletes and world leaders to those who enjoy active lifestyles and want to ensure the best possible recovery from injuries.

University of Maryland School of Medicine to study swine flu vaccine

The University of Maryland School of Medicine will lead a research study on an experimental vaccine to prevent swine flu.

The school’s Center for Vaccine Development will participate in a nationwide network of vaccine evaluation teams funded by the National Institutes of Health.

Starting in August, the clinical trial will enroll as many as 1,000 adults and children at 10 centers to evaluate the safety of the vaccine and measure its ability to stimulate immune responses to the H1N1 influenza virus. The virus has been declared a global pandemic by the World Health Organization and has resulted in three deaths in Maryland.

The research is a first step toward the U.S. government’s goal of developing a vaccine before the flu season begins in the fall.

The University of Maryland’s partners on the effort include Baylor College of Medicine, Cincinnati Children’s Hospital Medical Center, Emory University, Saint Louis University, Seattle Group Health Cooperative, the University of Iowa, and Vanderbilt University.

Wednesday, July 22, 2009

Meta-analysis: Can Helicobacter pylori Eradication Treatment Reduce the Risk for Gastric Cancer?

Background: Helicobacter pylori infection is associated with gastric cancer, but the effect of eradication treatment on gastric cancer risk is not well defined.

Purpose: To determine whether H. pylori eradication treatment can reduce the risk for gastric cancer.

Data Sources: PubMed, EMBASE, Cochrane Library, Google Scholar, and online clinical trial registers through 31 January 2009, without language restrictions.

Study Selection: Randomized trials that compared eradication treatment with no treatment in H. pylori–positive patients and that assessed gastric cancer or progression of preneoplastic lesions during follow-up.

Data Extraction: Two authors independently reviewed articles and extracted data.

Data Synthesis: Seven studies met inclusion criteria, 1 of which was excluded from pooled analysis because of clinical and methodological heterogeneity. All studies were performed in areas with high incidence of gastric cancer, mostly in Asia. Overall, 37 of 3388 (1.1%) treated patients developed gastric cancer compared with 56 of 3307 (1.7%) untreated (control) participants. In a pooled analysis of 6 studies with a total of 6695 participants followed from 4 to 10 years, the relative risk for gastric cancer was 0.65 (95% CI, 0.43 to 0.98).

Limitations: All studies but 1 were performed in Asia. Only 2 assessed gastric cancer incidence, and only 2 were double-blinded.

Conclusion: Helicobacter pylori eradication treatment seems to reduce gastric cancer risk.

Prevalence of Lower Urinary Tract Symptoms Related with Benign Prostatic Hyperplasia. Study of 1804 Men Aged 40 or Older in Madrid - Abstract

Unidad de Apoyo a la Investigación, Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid.

Lower urinary tract symptoms (LUTS) related with benign prostatic hyperplasia (BPH) are present nowadays in approximately 20 to 30% of the Spanish male population from the age of 50 onwards. The purpose of this study was to assess clinical and epidemiological characteristics of patients with LUTS.

A cross-sectional study was performed, between 1999 and 2000, among 1,804 men aged 40 or older who were living in Madrid. Subjects were interviewed by telephone; socio-demographic information was requested and the presence of LUTS was assessed using the International Prostate Symptoms Score. Informed consent was requested, Association between qualitative variables was evaluated by chi2 or Fisher's test. A logistic regression model was performed to control confusion.

Prevalence of moderate/severe LUTS was 16.6% (95%CI: 14.8-18.3). Nearly 90% of the subjects consumed olive oil, 71.5% alcohol, 63.1% did not smoke and 96.9% did not consume drugs. A 27.7% of the subjects had hypertension and 8.8% referred diabetes. Men aged 70 or older had a threefold increased frequency of serious symptoms compared to younger men (OR: 3.31; 95%CI: 2.10-5.22). Low level of studies increased this frequency by a factor of 2.2 (95%CI: 1.42-3.46) and men who consumed only seed oil had twice more serious symptoms than those who consumed olive oil (OR: 1.86; 95%CI: 0.98-3.55).

Family history of urological diseases, age, low level of studies, hypertension, diabetes and seed oil consumption were independently associated with more serious symptoms, while medium alcohol consumption and mild smoking habit were associated with slighter symptoms.

Tuesday, July 21, 2009

New Molecular Pathway For Targeting Cancer, Disease Discovered

A UCLA study has identified a way to turn off a key signaling pathway involved in physiological processes that can also stimulate the development of cancer and other diseases. The findings may lead to new treatments and targeted drugs using this approach.

In the study, which is currently available in the online edition of the journal Molecular Endocrinology, scientists found that by activating a receptor in cells called the liver X receptor (LXR), they were able to inhibit the hedgehog (Hh) signaling pathway, which is involved in the maintenance of tissue integrity and stem cell generation. When stimulated in an unregulated manner, however, the Hh pathway can also cause cancers of the brain, lung, blood, prostate, skin and other tissues.

Blocking such unregulated stimulation of the Hh pathway had previously been shown in animal studies to prevent cancers, according to the researchers. How LXR was able to inhibit tumor cell growth by impeding the Hh pathway was previously unknown.

"Our finding shows that activation of LXR signaling is a novel strategy for inhibiting Hh pathway activity and for targeting various cell types, including cancer cells, which may provide important clues as to how we might be able to intervene with tumor formation," said Farhad Parhami, a professor of medicine at the David Geffen School of Medicine at UCLA and the study's principal investigator.

During the study, researchers performed various tests activating LXR receptors in cells and found that specific gene expression induced by the Hh pathway could be inhibited. This finding was also confirmed in mice.

"Since Hh signaling plays a major role in other physiological and pathological processes, we may be able to impact other diseases as well," Parhami said.

Dr. William Matsui of Johns Hopkins Medical Institute, an expert on Hh signaling in cancer development, noted the importance of the UCLA study and its significance for the next stages of research — finding a pharmaceutical drug or substance molecule to act as an agonist, which would stimulate LXR activity to inhibit aberrant Hh signaling.

"The hedgehog Hh signaling pathway is an important regulator of tumor formation, and these findings suggest that LXR agonists may be novel treatments for a wide variety of human cancers," Matsui said.

According to researchers, utilizing this new treatment pathway could have broad applications in the cancer field.

"This discovery identifies an entirely new and unexpected mechanism of hedgehog pathway modulation," said study author Dr. James A. Waschek, an expert on Hh signaling in brain tumor development and a professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA. "This has great potential in offering other options, because current hedgehog pathway inhibitors have severe side effects which preclude their use in many cancer patients, especially children."

Waschek also noted that this discovery may reveal new details on how Hh signals within the cell, which is currently poorly understood.

The next stage of the research will focus on activating the LXR pathway using various pharmacological molecules to inhibit tumor formation. Matsui will be a collaborator in this follow-up research.

In addition, the team has started a medicinal chemistry program to design and test small molecules that activate the LXR pathway while avoiding the adverse effects that may be caused when LXR is activated in tissues such as the liver.

The study was funded by the National Institutes of Health and the American Heart Association.

Other authors include Woo-Kyun Kim and Vicente Meliton from the UCLA Department of Medicine; Peter Tontonoz from the UCLA Department of Pathology and Laboratory Medicine and the Howard Hughes Medical Institute; Kye Won Park from the department of food science and biotechnology at Korea's Sungkyunkwan University; Cynthia Hong from the Howard Hughes Medical Institute and the David Geffen School of Medicine at UCLA; Pawel Niewiadomski from the UCLA Department of Psychiatry; and Sotirios Tetradis from the UCLA School of Dentistry.

Earlier HIV Antiviral Treatment Can Be Cost Effective In Areas Of Limited Resources, South African Study Finds

Early initiation of lifesaving antiretroviral therapies should be the standard of care for all HIV-infected patients, even those in countries with limited medical and financial resources, according to a study led by researchers at Massachusetts General Hospital (MGH) and the Desmond Tutu HIV Centre, University of Cape Town, South Africa.

The team reports in the August 4 Annals of Internal Medicine that starting antiretroviral therapy (ART) when the level of CD4 T cells drops below a threshold of 350 per microliter of blood, compared with below 250, would prevent nearly 76,000 deaths and avert 66,000 opportunistic infections over the next five years at an estimated cost of $1,200 per year of life saved. The study's publication coincides with the International AIDS Society Conference meeting which started yesterday in Cape Town.

The study provides strong support for broadening the eligibility standards for ART in settings with sufficient access to drugs, the authors note. In the U.S. and other developed countries, ART is usually initiated when the CD4 count – a measure of immune system function – drops below 350. Recognizing that ART is both costly and can have significant side effects, the 2006 World Health Organization (WHO) treatment guidelines suggest waiting until CD4 counts drop below 200 or until patients develop AIDS-related complications.

"While those standards accommodate the limited resources and short supply of medications in many settings, the greater prevalence of tuberculosis and other opportunistic infections in places like South Africa argue for earlier treatment initiation, even before the results of ongoing clinical trials are known." says Rochelle Walensky, MD, MPH, of the MGH Division of Infectious Disease, associate professor of Medicine at Harvard Medical School, who led the study.

Definitive clinical trial findings will not be available for several years. Yet in countries like South Africa, which currently has the world's highest burden of HIV infection, information is needed today to guide treatment policies and practices. To address this need, Walensky and colleagues developed a mathematical model to simulate HIV treatment and its associated health and economic outcomes. The model calculated the additional costs of earlier treatment, its potential toxicities and its benefits, including TB prevention. It also calculated how much delaying ART would shorten patients lives and then estimated the cost per extra year of life gained – a standard measure of cost-effectiveness – of earlier ART initiation.

"The time has come to act on the information we now have, nearly all of which supports starting treatment earlier. We can re-evaluate the situation after the trials, but until those results are available, the evidence points to saving lives with earlier treatment," says co-author, Robin Wood, FCP, MMed, DTM&H, director of the Desmond Tutu HIV Centre at the Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, a leading HIV clinical research group in South Africa

Additional co-authors of the Annals of Internal Medicine report are Lindsey Wolf, Mariam Fofana, and Kenneth Freedberg, MD, MSc, MGH; Elena Losina, PhD, Brigham and Women's Hospital; Neil Martinson, MBBCh, MPH, WITS Health Consortium, Johannesburg, South Africa; A. David Paltiel, PhD, Yale University; Xavier Anglaret, MD, PhD, University of Bordeaux, France; and Milton Weinstein, PhD, Harvard School of Public Health. The study was supported by grants from the National Institute for Allergy and Infections Diseases and the Doris Duke Charitable Foundation.

People that use food as medicine: using nutrition to find the causes behind the symptoms

Food misinformation and lack of disclosure are the two hottest nutrition controvsery debates. The third is on how to prevent childhood type 2 diabetes. There are more people that make their living from the cancer industry, including the larger pharmaceutical companies making drugs to treat cancer, than there are patients that suffer from cancer, according to some media reports. The opposite side of the debate says drugs don't give people stronger immunity. Food does. World War One mustard gas technology derivatives are still being used to treat cancer in current times.

What does the average person do when a new study comes out saying that a food has specific health benefits, but then soon after, another study is released noting that the same food has negative health consequences? This type of debate has opened the field of nutrition to debate.

Nutrition debates include asking questions such as what health issues surround studies of soy products, homogenized milk, and margarine? Why are the ingredients in the nutritional supplement bottle different from what the label says? Why do media report so often that we're losing the war on cancer and degenerative diseases?

How does the average consumer with no science training make informed decisions about what foods are healthy for each person or for all individuals? Would the average consumer benefit by a costly test to determine whether one’s genetic signature is helped or harmed by ingestion of a specific food or medicine? Are those tests accurate? Such topics are ripe for debate.

The hottest controversies in nutrition appear daily in various popular media—newspapers, general consumer magazines, and the tabloid press. However, three equally important controversies in nutrition actually are science versus nature, childhood obesity, and the ever-increasing type 2 diabetes epidemic in children and adults. Consumers want to know whether what’s on the label is the same as what’s in the food or nutritional supplement.

According to the International Food Information Council (IFIC) nutrition/food safety staff, while there are nutrition controversies almost too numerous to mention, a couple stand out – food ‘myths’ (or misinformation) concerning the safety/health benefits of consuming fish and seafood, especially canned tuna; and continuing misinformation about the safety of low-calorie sweeteners, such as Aspartame.

Monday, July 20, 2009

UPDATE 1-Drug firms offer to lower prices in Philippines

Big international pharmaceutical firms in the Philippines have offered to lower prices of dozens of best-selling drugs to stop the government imposing price controls, an industry spokesman said on Monday.

The government said it would still consider putting price ceilings on about six to seven products because the cut offered by drug companies was way below the 50 percent reduction mandated by law, Health Secretary Francisco Duque told reporters.

"We have to do what we need to do," Duque said after reviewing the proposals. "I think they have been selling medicines in this country for such a high price compared to the other countries. So, they've generated hefty profits from the Filipinos for the longest time."

He said the new prices for about 80 drug products would take effect on Aug. 15 after the president signs an executive order this week.

On Saturday, about 50 drug-makers led by the world's largest, Pfizer Inc (PFE.N) of the United States, voluntarily offered to lower prices by an average of 50 percent for about 80 drug products for illnesses such as hypertension, cancer and diabetes to beat a government deadline.

The industry's offer to cut prices could reduce sales by as much as 7-10 billion pesos ($146-208 million) a year, making it hard for smaller drug companies that produce and market three or four products to survive, said Reiner Gloor, head of the local pharmaceutical and healthcare industry group.

The Philippines passed a law in 2008 to lower medicine costs, mandating the president to impose price ceilings on commonly used drugs, which have sold for as much as 200 percent higher than in other Asian countries such as India and Thailand.

The industry opposed moves to introduce price controls, looking at the maximum retail price mechanism under the law as a form of regulation, said Gloor, adding some drugs could continue to be inaccessible to the poor unless the healthcare system was reformed.

"That sends a wrong signal for the country, which has followed free market policy," Gloor told Reuters in an interview. "We've given the president an option in making a decision on whether there should be price control or not.

"It's something the president would like to have, considering that this has become a popular issue in an interesting period we are entering in the country," Gloor said, referring to general elections in May 2010.

The Philippines imposed price controls on medicines during the 1970s when the country was under martial law before the late dictator Ferdinand Marcos was toppled by a popular uprising in 1986. (Reporting by Manny Mogato; Editing by Rosemarie Francisco)

U.S. already has socialized medicine

We already have socialized medicine in the U.S. It’s called the VA. We already cover everyone over 65. It’s called Medicare. Most states have health care available for everyone under age 16. At the very least, why not extend to everyone the possibility of opting into a public plan?

The health insurance industry cries “foul!” But aren’t they the ones who’ve been denying coverage, rationing treatment and withholding payment to those who need it most? Why are they so afraid of competing with a public plan?

Bottom line: We need comprehensive health care for all, not some patchwork plan that doesn’t address the core issue.

Sunday, July 19, 2009

Integrative Medicine: Red yeast rice targets cholesterol

Millions in the United States take medications called statins to lower blood cholesterol. These meds, including Lipitor, Zocor and Mevacor, have made a huge difference for people with high cholesterol levels, especially those with cardiovascular disease or who are at risk of heart attack and stroke.

However, side effects such as muscle aches are common (as high as 10 percent) with these drugs. Some alternative practitioners recommend using co-enzyme Q10 to prevent this type of muscle pain, but a recent review showed no clear benefit from this supplement.

One popular alternative medicine product for high cholesterol is red yeast rice, a dietary supplement that has been used in China for centuries. RYR contains a chemical, monacolin-K, that is identical to the active ingredient in the prescription statin Mevacor (lovastatin). And RYR does not seem to cause the side effects .

A new study reported in the Annals of Internal Medicine has shown that RYR may be a safe alternative for people who have been intolerant of statins. In this study, 62 patients who had stopped taking at least one statin drug because of muscle pain were randomized to receive either red yeast rice or a placebo twice daily for 24 weeks. All patients were encouraged to eat a healthy diet, exercise and reduce stress, all of which can also lower blood cholesterol. The patients receiving RYR got the equivalent of about 6 mg of lovastatin daily; by the end of the study, they had dropped their total cholesterol by about 15 percent and their LDL cholesterol by about 21 percent, compared with 5 percent to 9 percent in the placebo group. And muscle pain was uncommon in this study.

It is not known why RYR may be better tolerated than prescription meds. RYR contains a number of plant chemicals that may be beneficial in lowering cholesterol without causing side effects. Also, this study may not have been long enough to detect side effects of RYR.

Are there downsides to taking RYR? Yes. RYR can be contaminated with a kidney toxin known as citrinin. We recommend using only RYR products that have been evaluated by independent testing labs. RYR has also been reported to cause muscle pain and liver problems just like statin meds, though it seems that side effects from RYR are rare. Still, we recommend that you be monitored by your physician should you choose to take RYR.

And RYR has not been compared with a statin med in a medical study – this would give us a direct comparison. Until it is, we suggest lifestyle changes: a low-fat, high-fiber diet and exercise to reduce your cholesterol.

Socialized medicine

Ted Kennedy's socialized medicine bill includes provisions to exempt members of congress from socialized medicine. Our hero of the Chappaquiddick wasn't drunk again; he just knows the truth about socialized medicine.

Teddy may want access to new drugs. In socialist England, government cut costs by limiting access to new prescription drugs. Many drugs widely available here are unavailable in socialist Europe.

Teddy doesn't want to wait to see a doctor. In England the average wait is 8.6 months. You can die waiting your turn. Breast and prostate cancer have a 10-34 percent higher survival rate in the United States than in Europe. Waiting lines may be a factor.

Teddy wants a clean hospital. In England, they have an increased rate of antibiotic-resistant staph infections because government cut costs in the area of sanitization.

We can visit our crumbling, outdated and poorly staffed VA hospitals to see why congress doesn't want to participate in socialized medicine. According to an American Legion survey, vets waited an average of seven months for a first appointment at a VA hospital. ABC News reported allegations of patients having to beg for food, amputations because of poor care, and doctors repeatedly losing test results.

Congress also doesn't want its "employer paid" benefit replaced with an additional tax of 10-20 percent (or more) of their earnings. This would be enough to put the American Dream out of reach for most Americans.

Socialized medicine won't be optional for you. Most employers will unload their health insurance expenses on the government. The rest (except Congress) will join once the government bankrupts the health insurance industry. Under "Hillary Care" you would have faced criminal charges for taking your own money and seeking medical care outside of the system, even to save your life.

Saturday, July 18, 2009

Weight gain during menopause tied to brain changes

Healthy women who put on weight between the premenopausal and postmenopausal years risk losing nerve cells in the brain, research suggests.

Gaining weight is a "highly modifiable" risk factor that may be targeted to prevent or slow the progression of potentially harmful age-related changes in the brain, the University of Pittsburgh-based study team suggests in the June issue of Psychosomatic Medicine.

Dr. Isabella Soreca and colleagues analyzed brain imaging data obtained from 48 healthy older women who were tracked over a 20-year period as part of the longitudinal epidemiological Pittsburgh Healthy Women Study.

They report in the journal Psychosomatic Medicine that an increase in body weight during the transition to menopause and beyond was "uniquely associated" with a lower volume of gray matter (the portion of the brain containing nerve cell bodies).

Soreca and colleagues say this finding is "particularly noteworthy" given that these were healthy older women who entered menopause naturally and had no history of cardiovascular disease or psychiatric disease and none were obese in mid-life or later on.

"Women may be particularly motivated to maintain a healthy weight in the postmenopausal years, should it be confirmed that weight gain causes alteration in brain function that is important to quality of life," Soreca and colleagues conclude.

Patients to Pay for Swine Flu Medicine

Finland intends to remove the H1N1 swine flu virus from the list of common dangerous infectious diseases this month. Patients not belonging to risk groups will also have to pay for medicines.

Health officials say the disease has proven to be less serious than anticipated and will be classified in the same way as other seasonal influenza viruses.

Those contracting the virus will be treated by the country's basic healthcare system and antiviral medicine will be prescribed only if necessary. The move follows a situation report issued on Thursday by the Ministry of Social Affairs and Health.

A government decision to remove H1N1 from the list of dangerous diseases is expected later this month.

Friday, July 17, 2009

Swine flu medicine available via GPs

AN ANTI-VIRAL medicine used to treat the symptoms of swine flu should be available in pharmacies around the country from today – but only on prescription.

Dr Pat Doorley, the national director of population health with the Health Service Executive (HSE), said Tamiflu had been delivered to community pharmacies and GPs in recent days. Dr Doorley confirmed at a briefing on the virus in Government Buildings last evening that Tamiflu would only be available with a prescription.

Meanwhile, the World Health Organisation (WHO) said yesterday the pandemic was the fastest-moving ever and that it was now pointless to count every case. It revised its requirements so that national health authorities need only report clusters of severe cases or deaths caused by the virus.

The WHO said past pandemics had needed more than six months to spread as widely as the new virus had in six weeks.

Earlier this week, chief medical officer Dr Tony Holohan predicted swine flu could infect one million people in the State as it spreads later in the year. Dr Holohan said 146 cases of swine flu had been confirmed here as of yesterday.

He said the vast majority of people who contracted swine flu would recover from the virus without taking Tamiflu and stocks of the anti-viral would be reserved for treating severe infections.

Dr Doorley said the HSE had access to anti-virals to treat more than half the population and he was confident this was enough to treat a more serious scenario than that currently facing the HSE.

“We do not want over-use. We do not want resistance developing to these drugs. We are not concerned that we do not have enough Tamiflu. We should have enough and we can order more.”

The strategy of the Department of Health and the HSE officially changed yesterday because they believe preventing the virus’s spread is no longer an option.

Ponton Establishes South Carolina Oriental Medicine Association

Dr. Marina Ponton, owner of Greenville Natural Health Center, has established the South Carolina Oriental Medicine Association, a professional organization affiliated with the American Oriental Medicine Association. The new statewide association is dedicated to the integrity, safety, excellence, and advancement of Traditional Chinese Medicine by adhering to the highest standards of the profession.
An acupuncture physician specializing in women's health, Ponton recently returned from the
Chengdu University of Traditional Chinese Medicine in China where she participated in the three-week study program on integrating Chinese herbal formulas into Western treatments for endocrine disorders. Ponton was selected as the only member of her 2010 doctorate class at the Oregon College of Oriental Medicine in Portland to attend the women's health initiative.
Ponton opened Greenville Natural Health Center in 2007, specializing in women's health and wellness. The Center integrates biomedicine (Western medicine) with traditional Chinese medicine (TCM), utilizing a holistic (mind-body) approach to issues such as chronic fatigue, menopause and infertility. Ponton was featured in the February 2009 issue of Alive magazine, Canada's leading publication in the field of health and wellness, about her success in treating infertility with acupuncture. Her studies include the American University of Paris, FAMU University in Prague, The University of Miami, and The Atlantic Institute of Oriental Medicine.

Thursday, July 16, 2009

Basketball the right medicine for Mark Pope

When Mark Pope was admitted into medical school at Columbia University in New York City, he wasn't certain what specialty he would eventually pursue. He knew only that he wanted to help people and that practicing medicine would be a noble way to do it.

So for three years Pope studied, often as many as 16 hours a day. For the last five months he worked shifts at New York Presbyterian Hospital. He connected with patients, people he believed he helped.

"I loved being with patients," he said. "Absolutely loved it."

Pope did not love the 16-hour study sessions, not with a wife (Lee Anne) and four daughters 8 and under. He did not love being separated from basketball. After playing center for the University of Kentucky's 1996 NCAA championship team, he bounced through the NBA for parts of six seasons. According to, he earned more than $4million in the NBA, and he also played in Europe.

In 2008, after his second year at Columbia, Pope called University of Louisville coach Rick Pitino, his former coach at UK, and told him he was considering leaving med school.

"Mark said he wanted to coach at the college level but that he didn't want to start at the bottom," Pitino said. "I told him, 'I'd like to be president, too, but that's not how it works.' I told him he really needed to be sure that coaching was his passion."

Pope, 36, stayed for a third year at Columbia, an Ivy League school that admitted less than 6percent of its male applicants in the Class of 2012. Then this past spring he made a second call to Pitino.

"I had this offer from the University of Georgia, and I told Coach I thought I was going to do it," Pope said.

"I told him if coaching was truly in his heart, that he should do it," Pitino said.

Pope did it. On July 6 he worked his final shift at New York Presbyterian, withdrew from Columbia and accepted an offer from new Georgia coach Mark Fox to become basketball operations coordinator. That has been his job for the last week, helping Fox build a program to compete in the Southeastern Conference. Pope had played two seasons for Fox at the University of Washington before he transferred to UK for his final two years.

UnitedHealth and Cisco push online medicine

Unitedhealth, one of the nation's largest health insurers, said Wednesday it will partner with computer networking firm Cisco Systems Inc. to create an electronic network linking patients with doctors across the country.

The cooperative project, dubbed Connected Care, will place video terminals in office buildings, malls and other locations to help patients reach health care providers at remote locations.

The effort comes as President Obama and congressional Democrats promote technology as part of a sweeping effort to make health care more efficient and affordable.

"Both the White House and Congress see this as one of the enabling technologies in the modernization of health care," said UnitedHealth Group Inc. Executive Vice President Steve Rodgers.

The combination of video conferencing and medical care also represents a significant financial opportunity for the companies. The so-called telemedicine market is expected to mushroom in coming years, as the U.S. government has already invested $2.5 billion in the technology.

Driving the demand for high-tech medical consultation is a growing shortage of primary care physicians, particularly in poor and rural areas of the country. Earlier this year the Association of American Medical Colleges said that by 2025 the U.S. will have 159,000 fewer doctors than it needs.

While some diseases will always require an in-person meeting, UnitedHealth executives say doctors can diagnose and treat a variety of ailments electronically.

"The vast majority of time doctors spend with their patients is spent talking and listening, and that can be done remotely," said Dr. Jim Woodburn, UnitedHealth's vice president and medical director.

Besides diagnosing the common cold, Woodburn said doctors can use the technology to monitor patients' weight, calorie intake and blood sugar levels.

UnitedHealth of Minnetonka, Minn., did not provide an exact price tag for the project but said it has already invested "tens of millions" of dollars in the project. Eventually executives hope to make Cisco's telemedicine technology available almost everywhere: from the home to the work place to retail centers.

"It's all about moving the center of care from the fixed brick and mortar building of the doctor's office to anywhere the patient is," said Rodgers.

Wednesday, July 15, 2009

Promising Alzheimer's drug boosts toxic protein

Dimebon, Medivation Inc's (MDVN.O) promising experimental Alzheimer's drug, significantly raised levels of a toxic protein in the brains of mice, yet has been shown to delay thinking problems in human dementia patients, U.S. researchers said on Wednesday.

"This is an unexpected result," said Dr. Samuel Gandy, a researcher at Mount Sinai School of Medicine in New York, whose findings were presented at an Alzheimer's meeting in Vienna.

The study raises new questions about how the drug works and new worries about drugs meant to remove telltale clumps of a protein called beta amyloid from the brain as a way to reverse Alzheimer's disease.

Researchers are not sure whether amyloid is a cause or a symptom of Alzheimer's but, either way, getting rid of it had appeared to be a good thing.

"We think we want amyloid levels to go down," Gandy said in a telephone interview. "Here is this compound that is looking very promising clinically that is making amyloid levels go up."

Dimebon, first sold in Russia as an antihistamine, is being developed jointly with Pfizer Inc (PFE.N), maker of the Alzheimer's drug Aricept.

Researchers see Dimebon as the best hope for a new treatment for the incurable, mind-robbing disease that affects 26 million people globally.

Now in late-stage testing, Dimebon seems to delay thinking problems in people but it is not clear how.

"We wanted to know what Dimebon was doing to amyloid," Gandy said.

His team tested mice genetically engineered to have a human form of Alzheimer's. The drug increased amyloid outside nerve cells.

Sports medicine specialist to address young athletes in Norton

Joseph Congeni, MD, director of Sports Medicine at Akron Children’s Hospital, will give a talk from 7 to 9 p.m. on Aug. 5 at the Norton Community Center on weight training for middle and high school athletes and the use of steroids and supplements in youth athletics.

Dr. Congeni’s talk, sponsored by the Player’s Choice Athletics, is targeted to youth sports teams and all young athletes are invited to attend. Dr. Congeni will also take questions from the audience.

Students are free and adults are $5.

Dr. Congeni is board certified in pediatrics with an added qualification in sports medicine. He has served on the executive committee of the American Academy of Pediatrics, Council on Sports Medicine and Fitness, and developed the primary care pediatrics sports medicine fellowship at Akron Children’s, the first of its kind at a pediatric hospital in the United States.

He is a professor of pediatrics at the Northeastern Ohio University College of Medicine and in 2008 was named the Ohio Outstanding Team Physician by the Ohio State Medical Association and the Team Physician of the Year by the Ohio Athletic Trainers’ Association. He is a team physician for the University of Akron and Archbishop Hoban High School and discusses current issues in sports medicine in a weekly radio segment on WAKR AM.

Dr. Congeni has published many papers with special interest in lumbar spondylolysis, youth baseball injuries and brain injuries in young athletes.

Tuesday, July 14, 2009

Who really profits from digital medical records?

An unprecedented effort to computerize the nation's hospitals and physician offices could be the key to reducing crippling health care costs – or a giveaway to technology vendors whose sales will be subsidized by taxpayers.

Computerizing the paper-based world of medicine was a significant component of this year's $787 billion stimulus package, which reserved $45 billion for hospitals and physicians to adopt electronic health records.

The Obama administration argues that electronic records will allow doctors to coordinate care for the sickest patients, eliminate errors such as adverse drug reactions and avoid duplicate lab and imaging tests. Medical errors alone cost the country $37.6 billion each year, according to the Institute of Medicine.

Despite years of technology development, most hospitals and physician offices, including those in North Texas, can't electronically share information or even record patient data.

Data sharing confronts age-old assumptions that providers, not patients, own health records, which are valuable assets that can be used to obtain grants and market hospitals. It requires the government to decide what kinds of systems will improve care and how providers should use the systems to achieve that.

Special Journal Issue Focuses on Family Medicine Obstetrics

Family Medicine Obstetrics is the featured topic of the current special issue of the American Journal of Clinical Medicine.

Daniel M. Avery, MD, FACOG, FACS, is the author of several articles in the issue including The History of Board Certification of Family Medicine Obstetricians. Dr. Avery, Associate Professor and Chair of the Department of Obstetrics and Gynecology at the University Of Alabama School Of Medicine, is Chair of the recently formed American Board of Family Medicine Obstetrics (ABFMO).

“Attempts to recognize and certify Family Medicine Obstetricians have been a long term task, dating back to the 1980s,” said Dr. Avery. “ABFMO will provide certification in support of family physicians that have completed advanced training in maternity care, including operative obstetrics.”

Other Special Issue Highlights Include:
• Four Part Series on Maternal Health
• Founder of Obstetrics Fellowships in the United States
• Postpartum Depression
• Prenatal Patients Not Delivered
• Obstetric Emergencies
• The Need for Rural Family Physicians Who Can Perform Cesareans
• Medical Ethics Without the Rhetoric
• Minilaparotomy Technique for Ectopic Pregnancy

To view the special Family Medicine Obstetrics issue online go to The American Journal of Clinical Medicine is the official, peer-reviewed journal of the American Association of Physician Specialists, Inc. (AAPS). The Journal is dedicated to improving the practice of clinical medicine by providing up-to-date information for today’s practitioners.

AAPS is a 501 (c)(6) not-for-profit organization providing a providing a clinically recognized mechanism for specialty certification for physicians who had obtained advanced training in various medical specialties. The American Board of Physician Specialties (ABPS) is the certifying arm of the AAPS, certifying and recertifying thousands of allopathic (M.D.) and osteopathic (D.O.) physicians from all 50 states and Canada in 16 medical specialties.

Monday, July 13, 2009

New Alzheimer's Disease Treatment Promising

Researchers at Mount Sinai School of Medicine have found that a compound called NIC5-15, might be a safe and effective treatment to stabilize cognitive performance in patients with mild to moderate Alzheimer's disease. The two investigators, Giulio Maria Pasinetti, M.D., Ph.D. , and Hillel Grossman, M.D., presented Phase IIA preliminary clinical findings at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD) in Vienna on July 12.
NIC5-15's potential to preserve cognitive performance will be further evaluated in a Phase IIB clinical trial. Early evidence suggests that NIC5-15 is a safe and tolerable natural compound that may reduce the progression of Alzheimer's disease-related dementia by preventing the formation of beta-amyloid plaque, a waxy substance that accumulates between brain cells and impacts cognitive function
"With Alzheimer's disease affecting 5.2 million Americans, another 5 million with early-state disease, and nearly a half million new cases reported annually, treatments like NIC5-15 would make a significant difference in the lives of many Alzheimer's patients," said Dr. Pasinetti, Professor of Psychiatry, Professor of Neuroscience and Professor of Geriatrics and Adult Development, in the Department of Psychiatry at Mount Sinai School of Medicine. "We are hopeful that the follow up clinical study will support this preliminary evidence."
"There are no FDA-approved Alzheimer's disease modifying drugs available today," said Dr. Hillel Grossman, Assistant Professor of Psychiatry, Co-Director of the Clinical Research Core of the Alzheimer's Disease Research Center, and Clinical Director of the Mount Sinai Memory and Aging Center. "Current drugs approved for use help maintain cognitive function, but only for a limited time. NIC5-15 is part of a new class of natural compound we found to have the potential of precluding the generation of β-amyloid and, eventually, attenuating cognitive deterioration in preclinical models of Alzheimer's disease."
The study was conducted at the Mount Sinai Alzheimer's Disease Research Center (ADRC). ADCR is a comprehensive research facility and clinical program dedicated to the study and treatment of both normal aging and Alzheimer's disease. The Center is supported by the National Institute on Aging, a branch of the National Institutes of Health. Humanetics Corporation, manufacturers of NIC5-15, sponsored the study. Phase IIB clinical trials on NIC5-15 are expected to begin later this year.
Disclosure: Dr. Pasinetti has a patent pending for the use of NIC5-15 in the treatment of Alzheimer's disease. The patent application was filed on his behalf by the Mount Sinai School of Medicine. Dr. Pasinetti and the School of Medicine could benefit financially from the results of this trial.

Breakthroughs in DNA medicine to revolutionise doctors’ training

Doctors are to be given more specialised training in genetics to prepare the NHS for a revolution in DNA-based medicine, The Times has learnt.
A review of medical education in genetics is to examine what doctors need to know about the influence of DNA on common diseases and patients’ response to drugs, so they can exploit science’s growing understanding of the human genome in clinical practice.
In an interview with The Times, Professor Peter Farndon, director of the National Genetics Education and Development Centre, said recent advances in genetic science made it essential for doctors to have more access to information.
Though the last genetics syllabus for medical students and junior doctors was introduced in 2006, so much has changed since then that the centre was already working to update it, he said. It was also developing guidelines for professional education in the field.
Over the past three years, costs of reading DNA have fallen so sharply that many scientists predict that it will be possible to sequence any individual’s entire genetic code for less than £1,000 within a year or two. Research has also revealed hundreds of genetic variations that affect an individual’s risk of disease or response to medicines.
Companies such as 23andMe and deCODEme have started to sell genome scans directly to consumers, assessing their genetic risks of developing a range of diseases for between £300 and £600.
Last week a report from the House of Lords Science and Technology Committee said that these developments required urgent reforms to medical training and NHS infrastructure so they could be translated into benefits for patients. The importance of genetic tests was “placing strain on the expertise of doctors, nurses and healthcare scientists, who at present are poorly equipped to use genomic tests effectively and to interpret them accurately, indicating the urgent need for much wider education of healthcare professionals and the public in genomic medicine”, the report said.
While doctors learn about genetics in undergraduate and postgraduate training, the focus is on rare disorders caused by mutations in single genes, such as Huntington’s disease and cystic fibrosis.
More recent genetic research has identified hundreds of DNA variants with more complex and subtle effects on a wide range of much more common conditions, such as heart disease, cancer and rheumatoid arthritis. Each raises or lowers a patient’s predisposition to disease only slightly, but can combine to create a significantly raised risk, and their influence can be difficult to interpret.
Family doctors, in particular, need an understanding of this area so that they can give appropriate advice to patients, Professor Farndon said.
Scientists have also started to discover genetic variants that affect whether drugs are likely to be effective, or the safe dose that a patient can take. This practice, known as pharmacogenomics, is forecast to become increasingly important to more personalised medicine, but currently it is not highlighted as an important teaching subject.
“It definitely needs to go into the main syllabus now, absolutely,” Professor Farndon said. “Suppose there’s a set of eight DNA variants that predispose a woman to a high risk of breast cancer. Even though she has no family history, you might target her for screening much sooner than the current recommended age.”

Saturday, July 11, 2009

'Jackson died of lethal levels of potent medicines, drugs'

The leaked toxicology report of Michael Jackson claims that the pop star had lethal levels of potent painkillers and drugs in his body at the time of his death, triggering suspicion that it may be a case of homicide.
Jackson was on a diet of deadly cocktail potent enough to have killed a normal person instantly but his body had developed a tolerance due to the longtime use of huge doses, the British newspaper Sun claimed quoting the findings of his preliminary toxicology reports.
Apart from high levels of Demerol, a strong painkiller and heroin substitute Methadone, Jackson's blood tests found high doses of antianxiety drug Xanax, according to the leaked toxicology report submitted to the Los Angeles county coroner's office, the paper said.
Lower levels of powerful anaesthetic drug Propofol was also present in Jackson's body. The medicine is used for surgical operations but according to Jackson's close aides, the pop star, who suffered from insomnia, used the medicine as a sleeping pill.
Another medicine, Dilaudid, which is normally used to numb post-surgery pain was also found in Jackson's body.
Jackson died after collapsing on June 25 just weeks before making his comeback in London and reports have linked his sudden death to the long abuse of prescription drugs.
Coroner's office is yet to release the toxicology report, which will determine the cause of death.
But daily claiming to have access to the report said besides Demerol and Methadone, 50-year old Jackson had taken four more painkillers and anaesthetics plus anti-anxiety pills.
"This is sure to increase pressure on police to establish exactly how one man obtained so many prescription medications — and which doctors were responsible."
"There is increasing talk of manslaughter charges if it can be shown he was given drugs without proper regard for his safety," the daily said claiming to quote a source close to the case.
Police Chief William Bratton added he was waiting for the final toxicology reports to move further in the investigation.
"Based on those, we will have an idea what we are dealing with. Are we dealing with a homicide or are we dealing with accidental overdose?" he said.
"Michael Jackson was a walking drug store when he died — he never stood a chance," the daily added.
"The body can build up extreme tolerances to huge doses of drugs but eventually it overloads and just shuts down. That is what happened to Michael," it said.
In addition to these medicines, there were "therapeutic" levels of Fentanyl, another post-operation painkiller 100 times more potent than morphine, plus prescription painkiller Vicodin, anti-anxiety pills Valium and the sleeping drug Ambien.

'Jackson died of lethal levels of potent medicines, drugs'

The leaked toxicology report of Michael Jackson claims that the pop star had lethal levels of potent painkillers and drugs in his body at the time of his death, triggering suspicion that it may be a case of homicide.
Jackson was on a diet of deadly cocktail potent enough to have killed a normal person instantly but his body had developed a tolerance due to the longtime use of huge doses, the British newspaper Sun claimed quoting the findings of his preliminary toxicology reports.
Apart from high levels of Demerol, a strong painkiller and heroin substitute Methadone, Jackson's blood tests found high doses of antianxiety drug Xanax, according to the leaked toxicology report submitted to the Los Angeles county coroner's office, the paper said.
Lower levels of powerful anaesthetic drug Propofol was also present in Jackson's body. The medicine is used for surgical operations but according to Jackson's close aides, the pop star, who suffered from insomnia, used the medicine as a sleeping pill.
Another medicine, Dilaudid, which is normally used to numb post-surgery pain was also found in Jackson's body.
Jackson died after collapsing on June 25 just weeks before making his comeback in London and reports have linked his sudden death to the long abuse of prescription drugs.
Coroner's office is yet to release the toxicology report, which will determine the cause of death.
But daily claiming to have access to the report said besides Demerol and Methadone, 50-year old Jackson had taken four more painkillers and anaesthetics plus anti-anxiety pills.
"This is sure to increase pressure on police to establish exactly how one man obtained so many prescription medications — and which doctors were responsible."
"There is increasing talk of manslaughter charges if it can be shown he was given drugs without proper regard for his safety," the daily said claiming to quote a source close to the case.
Police Chief William Bratton added he was waiting for the final toxicology reports to move further in the investigation.
"Based on those, we will have an idea what we are dealing with. Are we dealing with a homicide or are we dealing with accidental overdose?" he said.
"Michael Jackson was a walking drug store when he died — he never stood a chance," the daily added.
"The body can build up extreme tolerances to huge doses of drugs but eventually it overloads and just shuts down. That is what happened to Michael," it said.
In addition to these medicines, there were "therapeutic" levels of Fentanyl, another post-operation painkiller 100 times more potent than morphine, plus prescription painkiller Vicodin, anti-anxiety pills Valium and the sleeping drug Ambien.

WHO approves cervical cancer vaccine Cervarix

The World Health Organization has approved a second cervical cancer vaccine, this one made by GlaxoSmithKline, meaning U.N. agencies and partners can now officially buy millions of doses of the vaccine for poor countries worldwide.

GlaxoSmithKline PLC said in a statement Thursday the approval would help speed access to Cervarix globally.

WHO had previously approved Gardasil, a competing cervical cancer vaccine made by Merck & Co. With two cervical cancer vaccines now ready to be bought by donor agencies, officials estimate that tens of thousands of lives might be saved.

More than 80 percent of the estimated 280,000 cervical cancer deaths a year occur in developing countries. In the West, early diagnosis and treatment has slashed the disease's incidence.

Last year, the global health association GAVI, formerly known as the Global Alliance for Vaccines and Immunization, prioritized the purchase of cervical cancer vaccines for the world's 73 poorest countries. GAVI includes U.N. agencies, the World Bank and the Bill & Melinda Gates foundation and is a major buyer of vaccines for the developing world.

"We're very eager to offer women in developing countries these vaccines because without early screening, they are arguably more vulnerable to cervical cancer," said Dan Thomas, a GAVI spokesman. Thomas said the vaccine's price was essential to making it available to poor countries.

In the West, the vaccines typically cost about $360 for a three-shot dose — which is far too expensive for poor countries, Thomas said.

Thomas said GAVI is in talks with drugmakers, but that it is still not clear whether either Merck & Co or GSK might sell their vaccines to donor agencies at a cheaper price.

Cervarix has not been approved for use in the U.S. or Japan, but is available in 97 other countries. In the U.S., the cervical cancer vaccine market has been cornered by Gardasil since it was approved in 2006.

The FDA is expected to decide within the next few months whether to approve Cervarix. Gardasil racked up $426 million in global sales in the most recent quarter, versus $69 million for Cervarix, which has won more contracts from government health programs beyond the United States.