Monday, August 31, 2009

Cost of defensive medicine is indeed significant

Jay Hancock in his article regarding health care malpractice costs ("Health care myths obscure the much tougher decisions," Aug. 6) cites information from the Congressional Budget Office that "malpractice costs make up only 2 percent of health care spending" and WellPoint Insurance, which says litigation and defensive medicine "are not considered a significant recent significant factor in the overall growth of health care spending."

Well, I guess it depends on who you talk to.

In a Massachusetts Medical Society survey of 900 doctors published last November, 83 percent of Bay State physicians cited the fear of being sued in their decisions to practice defensive medicine. According to the doctors anonymously surveyed, on average, 18 percent to 28 percent of tests, procedures, referrals and consultations and 13 percent of hospitalizations were ordered to avoid lawsuits. All of this adds at least $1.4 billion to annual health care costs in Massachusetts alone, and national estimates range as high as $200 billion.

A 2006 Harvard School of Public Health study found that four out of every 10 medical malpractice lawsuits filed in America each year were "without merit." Nonetheless, defending against such lawsuits imposes costs on doctors, hospitals and insurers that invariably are passed on to health care consumers. Beyond the obvious costs of litigation, more subtle costs related to the practice of "defensive medicine" are contributing to runaway health care inflation.

Texas has joined 24 other states in enacting reforms that include a reasonable limit on noneconomic damages for pain and suffering of up to $750,000 per incident. This reform does not limit compensatory awards for calculable lost wages and medical expenses, but it does balance the interests of patients and care providers while helping to ensure access to necessary care. Now, according to Gov. Rick Perry, doctors' insurance rates have declined by an average of 27 percent while the "number of doctors applying to practice medicine in Texas has skyrocketed by 57 percent. In ... just the first five years after reforms passed, 14,498 doctors either returned to practice in Texas or began practicing here for the first time."

Thursday, August 27, 2009

Major Genetic Determinant Of Psoriasis

A specific genetic region that has been increasingly identified as the strongest genetic link to psoriasis has an even more significant role in the chronic skin disease than has been suspected, University of Utah medical researchers show in a new study.

n the Aug. 13 issue of PLoS Genetics, researchers in the U School of Medicine's Department of Dermatology confirm that the presence of HLA-Cw*0602, a gene variation or allele on chromosome 6 found to be associated with psoriasis by numerous investigators, is the "major genetic determinant" of psoriasis, but that other nearby genetic variations also play an independent role in contributing to the disease

"The HLA-Cw*0602 gene variation stands alone as a high risk for psoriasis," said Gerald G. Krueger, M.D., professor of dermatology, Benning Presidential Endowed Chair holder, and a co-author on the study. "A major question has been: are there other genetic variations in this region that associate with psoriasis?"

The study reported in PLoS Genetics identifies two other genetic variations on chromosome 6 that also have significant association with psoriasis. People who have all three genetic variations are nearly nine times more at risk for psoriasis.

Psoriasis is a chronic disease that causes red scaly patches on the skin and affects up to 7.5 million people in the United States. About 25 percent of subjects with the disease also develop a painful inflammation of the joints called psoriatic arthritis.

University researchers, led by first author Bing-Jian Feng, Ph.D., postdoctoral fellow, and senior author David E. Goldgar, Ph.D., research professor of dermatology in the U of U School of Medicine, reached their conclusion after an expanded analysis of data from a study published earlier this year by investigators at Utah in collaboration with colleagues from the University of Michigan and Washington University.

That study (Nature Genetics, Jan. 25) used new technology to scan nearly 500,000 genetic variants (single nucleotide polymorphisms or SNPs) in 1,359 people with psoriasis and 1,400 without to find those with the strongest relationship with psoriasis. After identifying 18 SNPs with the highest associations with psoriasis, the researchers expanded the study to include 5,048 people with psoriasis and 5,051 without the disease. From that, they identified four new genetic "hotspots" for psoriasis and confirmed two others that Krueger and colleagues identified in previous studies.

Using the data from the Nature Genetics study, Feng, Goldgar, and colleagues employed two statistical methods, imputation and logistic regression analysis, to determine with a much greater degree of accuracy those genes that have the highest association with psoriasis. Using imputation they were able to reliably predict the *0602 status of all subjects in the recent Nature Genetics study. This did two things; first, it increased the confidence that *0602 is the major genetic variation on this chromosome and, second, it permitted them to determine if there was any other associated genetic variation in this region.

Removing the strong effect of *0602 resulted in the identification of two other loci (fixed position on a chromosome) that are independently associated with psoriasis (MICA/HLA-B and c6orf10). These two loci increased the risk for the disease by 1.23 and 1.6 times, respectively. However, when all three genetic variations that Feng, Goldgar, and colleagues report are present, the risk for psoriasis is 8.9 times higher than when none of these is present.

To confirm the results, the researchers examined an independent patient population in China, which corroborated their conclusions.

While *0602 and the associated, but independent, genetic variations reported have a major genetic contribution to psoriasis, many other genes undoubtedly play a role, according to Krueger. The number of DNA sites discovered to have strong associations with psoriasis has more than doubled in the past two years.

Prepares for swine flu season

With an expected increase in the number of H1N1 virus cases as the school year kicks off, Texas Tech has ordered extra flu vaccines as well as updated a Web site designed to help students protect themselves against the flu.

According to a report released by the White House earlier this week, the H1N1 virus will kill between 30,000 and 90,000 Americans in 2009 with the season peaking mid-October.

In preparation, Dr. Kelly Bennett of the Family Medicine department said Tech has ordered 500 additional doses of the regular flu vaccine.

She said no Tech students were infected with H1N1 last year, but the university has been preparing for an outbreak projected to be more severe than last year.

According to Tech's flu Web site, students with the flu or flu-like symptoms are not to attend class or work for at least 24 hours after fever returns to normal and to consider vaccinations as they become available.

This follows the Centers for Disease Control and Prevention swine flu response guidelines for higher education released Aug. 20, which recommends students and faculty infected with H1N1 be isolated as much as possible.

"Texas Tech has been designated a point of dispensing, by the CDC," said Managing Director of Family Medicine Evelyn McPherson. "This should give students and faculty easy access to the vaccine."

The H1N1 vaccine, which must be taken as two separate doses, should be available to students in late September, Bennett said, and does not replace the regular flu vaccine.

"The CDC is setting up a provider registry of doctors and health departments to receive vaccines for H1N1," said Lubbock Public Health Preparedness Coordinator Sandy Fortenberry. "Of the 45 million expected vaccines, about 4 million will be allocated to Texas which will then go to registered providers."

In addition to getting the H1N1 vaccine, she said, students must take responsibility for their own health so they do not become infected.

"Students should do the same as they would with seasonal flu by practicing good hygiene, staying healthy and getting their seasonal flu shot," Fortenberry said.

The CDC also urges balance, and according to CDC H1N1 response guidelines, strategies employed by organizations should reduce the number of people who become ill or die from the flu while minimizing disruption.

"We are working to follow CDC guidelines which sometimes change from one day to the next depending on the severity of outbreak," McPherson said.

Incorporate traditional medicine into primary healthcare

Incorporating traditional medicine into primary healthcare system will improve the management of public health diseases, practitioners and experts agreed in Lagos on Wednesday. At a ceremony commemorating the African Traditional Medicine Day, marked every August 31, the Lagos State Commissioner for Health, Jide Idris, said that without traditional medicine, the realization of the millennium development goals will be a mirage.

"Traditional medicine which has been long neglected is the corner stone of an integrated healthcare system. We have yielded to the WHO's call as it is now part of our primary healthcare system in Lagos because we know that 80 per cent of the population patronize it. For about 33 years, the World Health Organization (WHO) had passed resolutions calling on member nations to give recognition to traditional medicine, but up till the moment, Nigeria has not passed the Bill on Traditional Medicine which will give it formal recognition in hospitals and regulation of the practice."

"There are challenges in making traditional medicine recognized in Nigeria," said Bunmi Omoseyindemi, the chairman of the Lagos State Traditional Medicine Board. "Insufficient evidence regarding safety and efficiency, inadequate coordination of existing practice and practitioners, lack of coordination among stakeholder and so on," Dr. Omoseyindemi added.

In a bid to effect these, the Lagos State passed the Health Sector Reform Law 2006, but many states are yet to incorporate it into their health system, and experts clamour for a national bill.According to the director general of the Nigeria Natural Medicine Development Agency, Tamuno Okujagu, the Bill was last heard in the National Assembly five years ago and nothing is being done up till now."Yet the WHO has reported that at least 80 per cent of the population patronize one form of Traditional Medicine or the other."

The head of sellers of herbs for women and children, Ashabi Olomowewe told NEXT that she inherited the practice for over 40 years from her for parents and it has never failed her."I trained all my children with herbs, today they are grown up alive and well." Mrs Olomowewe who is in her mid sixties said that her experience has saved many pregnant women from going for caesarean operation."The doctors will say that the baby has crossed (breach birth), but there are certain herbs that if given the women, the baby will take the normal position and the woman give birth normally not needing an operation.

Attesting to the power of the practice also is the chairman of the Nigerian Traditional Medical Association, W. Oshodi; "The practice of using herbs is a blessing from God. There are many diseases that doctors cannot cure, but herbs can cure, so we call on the government to give it more recognition and to stop the orthodox doctors from looking down on us."

Citing India and China as examples of countries that have taken advantage of traditional medicine, Mr. Okujagu added: "If we can give traditional medicine its due recognition, it will not only help our health care, it has the potential of yielding billions of naira yearly export."

Wednesday, August 26, 2009

UPDATE 1-Dainippon schizophrenia drug meets trial goals

apan's Dainippon Sumitomo Pharma Co Ltd (4506.T) said its experimental schizophrenia drug, lurasidone, was significantly better than placebo in a pivotal late-stage clinical trial, according to data released on Wednesday.

The company said it plans to submit its application seeking U.S. approval to sell the medicine early next year.

Dainippon Sumitomo will decide by autumn whether it will market the new drug, if approved, via its own sales network or a co-promotion deal with another firm or if it will acquire a U.S. company, a spokesman for the mid-sized drugmaker said.

Patients with acute schizophrenia in the 478-subject, six-week, Phase III trial received either 40 milligrams or 120 milligrams of lurasidone daily or a placebo.

Both doses of the drug proved to be statistically significantly better than placebo in the primary goal of the study, which was 30 percent or better improvement in the Positive and Negative Syndrome Scale, the company said.

Fifty-three percent of patients who received 40 mg of lurasidone and 47 percent of those on the 120 mg dose achieved the primary goal compared with 38 percent on placebo.

Both doses of lurasidone were also significantly more effective than placebo on a secondary measure used to test antipsychotic drugs called the Clinical Global Impressions Severity scale, the company said.

In previous trials, lurasidone was also tested at 80 mg and Dainippon Sumitomo said it would submit all three doses for FDA approval.

Lurasidone belongs to a class of drugs known as atypical antipsychotics and works by blocking serotonin receptors in the brain. If approved, it would join an already crowded field of such treatments.

"We're still searching for the right drug for many of these patients. There's no one size fits all," Dr Herbert Meltzer, one of the study's lead investigators and professor of psychiatry at Vanderbilt University School of Medicine, said in a telephone interview.

Patients in the trial had been diagnosed with schizophrenia on average for more than 13 years and most had been previously hospitalized prior to entering the study.

"If you look at the weight gain, the lipid changes, it's among the most benign of any antipsychotic drugs, clearly better than olanzapine, clozapine and Seroquel," Meltzer said.

Olanzapine is the chemical name for Eli Lilly and Co's (LLY.N) widely-used Zyprexa; clozapine in sold by Novartis AG (NOVN.VX) under the brand name Clozaril; and Seroquel is sold by AstraZeneca Plc (AZN.L).

Zyprexa and similar drugs can cause significant weight gain and have been linked to increased risk of diabetes.

But "this class of drugs as a whole is so superior to the first generation drugs," said Meltzer, who plans to present the data from the lurasidone trial at a major medical meeting in December.

Lurasidone was well tolerated with a discontinuation rate nearly identical to placebo -- 40 percent versus 39 percent -- and the adverse events were generally mild, such as restlessness and sleepiness.

"From the point of view of efficacy and side effect profile, once a day administration, the fact that the lower dose works as well as the higher dose, I think this is going to have a very good chance of major acceptance among my colleagues," Meltzer added. (Additional reporting by Yumiko Nishitani in Tokyo; Editing by Andre Grenon and Edwina Gibbs)

Tuesday, August 25, 2009

Use traditional medicine to fight flu

The head of a Manitoba First Nations organization is calling on his fellow chiefs to look to traditional aboriginal medicine to help fight the next wave of swine flu, also called H1N1.

Acting grand chief Norman Bone of the Southern Chiefs' Organization said he wants to drive home the fact that First Nations have access to traditional remedies to improve their health and treat the flu on their own, rather than waiting for funding announcements.

"It's more taking a step, doing what we can for ourselves," he said, adding that SCO would also welcome federal or provincial funding for traditional treatment, if an arrangement could be made.

Bone declined to say what types of roots, herbs or other remedies would be used to treat or prevent H1N1, based on the advice of elders. He said he's not suggesting people avoid vaccines in favour of traditional medicine.

"What I'm also promoting is the use of both methods," he said.

Residents of the northern Manitoba First Nations communities of St. Theresa Point and Garden Hill were the worst affected by the H1N1 flu so far, with hundreds of patients sick and dozens flown to Winnipeg for treatment.

Aboriginals make up less than four per cent of Canada's population but have accounted for 11.1 per cent of the total number of reported H1N1 cases, 15.6 per cent of the hospitalized cases, 15 per cent of the patients admitted to intensive care with it, and 12.3 per cent of the deaths.

In Manitoba more than one in four of the 886 individuals diagnosed with H1N1 are First Nations.

SCO health director Shirli Ewanchuk said the organization has been working with communities on pandemic planning since 2007, and is working to ensure there's a stockpile of traditional medicine for communities, including urban First Nations people.

Bone said he was pleased by last week's announcement that the province would spend $1.5 million to provide 15,000 medical kits including masks, tissue, hand sanitizer, rubber gloves and other supplies to First Nations.

Ewanchuk said with the kits paid for, the SCO can focus on making sure health centres in southern First Nations have the proper protective equipment and training, and lining up training for chiefs to deal with a flu pandemic, among other priorities.

Asthma sufferer fined $300 for ganja 'medicine'

SAN JUAN resident Lester Faustin was fined $300 yesterday for possession of 20 grammes of what he described as his "asthma medicine".

In this case, the "medicine" turned out to be the illegal drug marijuana.

Faustin who was arrested last Saturday after a warrant was executed at his girlfriend's Bourg Mulatrasse home, told Magistrate Andrew Stroude that he bought the "herbs" on the advice from an old lady named "Dolly", who prescribed the medication, minus the dosage.

Faustin added that "Dolly does sell bush", but quickly pointed out that it was not the kind of "bush" that he was arrested for.

"Since I start drinking the tea I breathing normal," said the 33-year-old shopkeeper.

He added that he was diagnosed with asthma since his birth but the problem got worse about four years ago when he "got a cut" on his chest.

Faustin was accompanied by his father who told Stroude that he tried speaking to his son about the illegal habit, without a favourable response.

Faustin said that he had trouble breathing at nights before he took the "medicine".

He told Stroude that the marijuana he was arrested for was "shake off", which was useless for smokers.

Faustin, who confessed to smoking marijuana in the past, added that he would "draw it and drink it in the morning".

Faustin then apologised for his actions and promised never to do it again, after which Stroude told him to "put aside his tea" and to seek medical attention for his bronchial problem before sentencing him.

Foreclosures Make for Subprime Mental Health

t's official: The economy is bad for your health.

Researchers at the University of Pennsylvania School of Medicine questioned 250 homeowners going through foreclosure in Philadelphia and found that 47 percent showed symptoms of depression, with 37 percent exhibiting signs of major depression. The rate was especially high considering previous research showed that only about 12.8 percent of people living in poverty were depressed, the study found.

"Although the health status of homeowners has traditionally tended to be better than that of renters, the financial and emotional stress of foreclosure may undermine the potential benefits of homeownership," said the study, which will appear in the October edition of the American Journal of Public Health.

The researchers found deep attachment to homes. "There is a sense of hope when people buy their homes," said Craig Evan Pollack, an internist who recently completed a fellowship at Penn's medical school and is now an associate scientist at Rand Corp. "The difference between those dreams and hopes and [the] reality that people are finding themselves in may be part of the stress that people are feeling, and a sense of sadness as well."

Borrowers facing foreclosure were more likely to forgo filling prescriptions, and nearly 60 percent reported that they had skipped or delayed meals, according to the study. "We've barely begun to think about the health consequences of the foreclosure crisis," Pollack said.

And it's likely to get worse. Nearly 2 million homeowners are expected to lose their homes to foreclosure this year, according to some economists.

"It's surprising to me that the rates of depression aren't even higher," said John Taylor, president of the National Community Reinvestment Coalition, a nonprofit group. "All aspects of their life are just disrupted. They lose their center."

Thursday, August 20, 2009

What killed Mozart?

For more than two centuries, the music of Wolfgang Amadeus Mozart has endured — as has the speculation about what led to his sudden death at age 35 on Dec. 5, 1791.

Was the wunderkind composer poisoned by a jealous rival? Did he have an intestinal parasite from an undercooked pork chop? Could he have accidentally poisoned himself with mercury used to treat a bout of syphilis?

A report in Tuesday's Annals of Internal Medicine suggests the exalted Austrian composer might have succumbed to something far more commonplace: a streptococcal infection — possibly strep throat — that led to kidney failure.

The researchers looked at death records in Vienna during the months surrounding Mozart's death — November and December 1791 and January 1792, and compared causes of death with the previous and following years.

"We saw that at the time of Mozart's death there was a minor epidemic in deaths involving edema (swelling), which also happened to be the hallmark of Mozart's final disease," said Dr. Richard Zegers of the University of Amsterdam, one of the study's authors.

There was a spike in swelling-related deaths among younger men in Vienna at the time of Mozart's death compared to the other years studied, suggesting a minor epidemic of streptococcal disease, Zegers said.

The cause of death recorded in Vienna's official death register was "fever and rash," though even in Mozart's time those were recognized to be merely symptoms and not an actual disease.

His surviving letters and creative output suggest that he was feeling well in the months before his death and was not suffering from any chronic ailment. Many accounts note that he fell ill not long before he died — suffering from swelling so severe, his sister-in-law recalled three decades later, that the composer was unable to turn in bed.

Others who reported to have been witnesses to Mozart's final days also described swelling, as well as back pain, malaise and rash — all symptoms that indicate Mozart may have died of kidney disease brought on by a strep infection.

"It's not definitive, but it's certainly food for thought," said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center who was not involved in the study.

He said it was not unreasonable to presume that Mozart died from strep complications, based on the information presented, but he pointed out that the authors had scant data to go on.

"Serious streptococcal infections were much more common than they are now and, indeed, they had very serious complications," he said. "This is sure to set off many discussions going forward."

US warns businesses to brace for H1N1

The federal government is urging employers to offer flexible sick leave policies as the nation braces for a second wave of the H1N1 influenza pandemic.

Commerce Secretary Gary Locke, Health and Human Services Secretary Kathleen Sebelius, and Homeland Security Secretary Janet Napolitano offered guidance to businesses on how to prevent the spread of H1N1, also known as swine flu, and to prepare for a major outbreak. They stressed allowing employees who exhibit flu symptoms to go home and to stay home until at least 24 hours have passed since their fevers subsided. They also said businesses should consider eliminating policies that require a doctor’s note or other proof to justify a sick day and that employers should be prepared to operate with fewer people.

“It’s more than just a significant health issue. It has the potential to affect every aspect of our lives,’’ Locke said. “It will take Americans from every walk of life pulling together and doing our part to mount an effective response.’’

As the first pandemic in more than 40 years, it has the potential to cause massive disruptions for businesses, schools, and governments. The United States and other northern nations have been scrambling to prepare for a resurgence of the virus by stockpiling flu treatments and vaccines.

US officials said yesterday that data from tests on adults show it is safe to start trying out the new vaccine in children. The National Institute of Allergy and Infectious Diseases said it would soon start two trials of a Sanofi-Aventis vaccine in children ages 6 months to 17 years. US health officials said 45 million doses of the H1N1 vaccine will be on hand in mid-October, when mass vaccinations are to begin.

Wednesday, August 19, 2009

Induced Labor May Prevent Need for Cesarean Section

Inducing labor doesn't necessarily increase the risk of Cesarean section delivery, according to a study that challenges the widely held opinion.

Researchers reviewed available data on elective induction, in which women choose to have labor induced rather than requiring it for medical reasons. Most of the studies included women who were about one week past their due date.

The review results suggest that, compared with waiting, elective induction of labor at or after 41 weeks' gestation lowered Cesarean delivery risk by 22 percent. In addition, women whose labor was electively induced were half as likely to have meconium-stained amniotic fluid, which is a sign of fetal intrauterine stress.

The findings suggest that elective induction of labor may be safer than continuing pregnancy past 41 weeks, according to the researchers at Stanford University School of Medicine and University of California, San Francisco (UCSF). Their study appears in the Aug. 18 issue of the Annals of Internal Medicine.

"It appears there is misunderstanding regarding the association of increased Cesarean deliveries with elective induction of labor, a procedure which has been rising in frequency," review lead author Dr. Aaron Caughey, an associate professor of obstetrics, gynecology and reproductive sciences at UCSF, said in a Stanford University news release. "However, our findings need to be tempered with women's and physicians' expectations of choosing to induce labor."

The message for pregnant women is that labor induction can be done without increasing Cesarean risk if doctors give induction sufficient time to work, said co-author Dr. Douglas Owens, director of the Stanford-UCSF Evidence-based Practice Center.

"Women should talk with their physician about how they would handle induction and what their approach to the procedure would be," Owens said in the news release.

Induced Labor May Prevent Need for Cesarean Section

Inducing labor doesn't necessarily increase the risk of Cesarean section delivery, according to a study that challenges the widely held opinion.

Researchers reviewed available data on elective induction, in which women choose to have labor induced rather than requiring it for medical reasons. Most of the studies included women who were about one week past their due date.

The review results suggest that, compared with waiting, elective induction of labor at or after 41 weeks' gestation lowered Cesarean delivery risk by 22 percent. In addition, women whose labor was electively induced were half as likely to have meconium-stained amniotic fluid, which is a sign of fetal intrauterine stress.

The findings suggest that elective induction of labor may be safer than continuing pregnancy past 41 weeks, according to the researchers at Stanford University School of Medicine and University of California, San Francisco (UCSF). Their study appears in the Aug. 18 issue of the Annals of Internal Medicine.

"It appears there is misunderstanding regarding the association of increased Cesarean deliveries with elective induction of labor, a procedure which has been rising in frequency," review lead author Dr. Aaron Caughey, an associate professor of obstetrics, gynecology and reproductive sciences at UCSF, said in a Stanford University news release. "However, our findings need to be tempered with women's and physicians' expectations of choosing to induce labor."

The message for pregnant women is that labor induction can be done without increasing Cesarean risk if doctors give induction sufficient time to work, said co-author Dr. Douglas Owens, director of the Stanford-UCSF Evidence-based Practice Center.

"Women should talk with their physician about how they would handle induction and what their approach to the procedure would be," Owens said in the news release.

Tuesday, August 18, 2009

Gut Checks Carry More Weight

When big-bellied patients come through the door of George Griffing's medical office in Brentwood, Mo., he pulls out a measuring stick.

Griffing, a professor of internal medicine at Saint Louis University School of Medicine, has those patients lie flat on their backs on an exam table. Then he measures the height of their bulging midsection from table top to tummy top.

"I'd like to use a ruler, but with a lot of patients I have to use a yardstick," he says. "What we're really looking for is how much fat is in the abdomen and the liver. It's simple and accurate and reveals a lot of information."

Medical experts have long suspected that people with excess deep-belly fat are at an increased risk for cardiovascular disease and Type 2 diabetes, and ongoing research bolsters that belief.

Griffing believes that measuring abdominal height is more efficient and accurate at predicting the risks of diabetes and cardiovascular disease than more commonly used methods such as calculating body mass indexes or waist-to-hip ratios, or measuring the circumferences of patients' waists. Those all factor in subcutaneous fat on arms, legs and hips, which is not as bad for you as fat in the gut, Griffing says. Griffing says most studies have found that abdominal heights that measure more than 10 inches in women and more than 12 inches in men triple the chance of cardiovascular disease.

The American Diabetes Association and the American Heart Association endorse using the midsection measuring technique. On its Web site, the American Diabetes Association calls it a simple, cheap and noninvasive tool but added that more research is needed.

Ibuprofen is best for kids with broken arms

Kids with a broken arm do better on a simple over-the-counter painkiller than on a more powerful prescription combination that includes a narcotic, a surprising study finds.

It tested ibuprofen, sold as Advil, Motrin and other brands, against acetaminophen plus codeine — a combo called Tylenol No. 3 that is also sold in generic form.

The children on ibuprofen did better, said the study leader, Dr. Amy Drendel of the Medical College of Wisconsin in suburban Milwaukee.

"They were more likely to play, they ate better and they had fewer adverse effects," she said.

Results were published online Tuesday by the Annals of Emergency Medicine. Experts praised the study as one of the few to compare medicines that have been long used in children based on how they work in adults.

"We want to start with what's effective and less likely to cause problems," and in this case, it turned out to be a cheap, over-the-counter drug, said Dr. Knox Todd, an emergency medicine pain researcher at Beth Israel Medical Center in New York and a member of the American Pain Society's board of directors.

The results do not mean that ibuprofen beats acetaminophen for everyday pain relief in children or anyone else, though. The study tested a specific use — pain in the first three days after a broken arm — and the acetaminophen was combined with the narcotic codeine, not tested alone.

Still, it shows the best way to treat a very common problem: As many as one out of five kids will break a bone before age 10 — often, an arm.

Researchers randomly assigned 336 children ages 4 to 18 to go home with liquid versions of either ibuprofen or the acetaminophen-codeine combo after being treated for a broken arm at Children's Hospital of Wisconsin. Neither the children, parents nor the doctors knew who received what treatment until the study ended.

Full results were available on 244 children. The portion who failed to get relief from their assigned medicine was roughly the same.

However, half of those on the combo medicine reported side effects — mostly nausea and drowsiness that can occur with narcotics like codeine — versus 30 percent of those given ibuprofen.

The ibuprofen users also had fewer problems eating, playing, going to school or sleeping. They and their parents reported more satisfaction with the treatment.

"A lot of emergency medicine physicians are afraid to give kids narcotics and a lot of parents are uncomfortable with narcotic medicine," so finding an effective alternative is good news, Drendel said.

The hospital and medical school paid for the study, and a hospital-related charity paid for $10 Toys R Us gift certificates for each participant.

The study has nothing to do with limits on Tylenol for adults that were recently proposed by an advisory panel to the federal Food and Drug Administration, said Todd, who is a member of that panel.

"Acetaminophen when taken as directed is a very safe drug. The problem is people taking too much," or its inclusion in drugs that people might not be aware of, he explained.

Monday, August 17, 2009

News Government considers herbal medicine ban

The government is considering measures that would effectively outlaw herbal medicine.

Such a move is likely to be welcomed by groups who campaign for evidence-based medicine. But others warned that prohibition could make it harder to regulate herbalists, by driving them underground.

The proposal came in a DoH consultation on plans to subject alternative medicine to professional regulation. Experts argue that this would offer cheaper and more effective protection of public safety than attempting to regulate individual remedies.

The consultation was expected to consider how to implement regulation. But instead it re-opens the question of whether statutory regulation is the best way to ensure public safety.

It offers alternatives including abolishing section 12 (1) of the 1968 Medicines Act, which allows herbalists to practice.

NHS Alliance chairman Dr Michael Dixon said that any move to regulate alternative medicines should be ‘totally pragmatic'. ‘The public are already seeing these practitioners,' he said. ‘We need to be assured that they are safe and know what they are doing within the modality of those treatments.'

Some health professionals want a tougher stance on herbal medicines, however.

Professor David Colquhoun, professor of pharmacology at University College London said: ‘Every other form of drug is tested for safety and efficacy. These guys have a complete loophole.'

He warned that many herbal medicines came in un-standardised doses, and statutory regulation would offer patients false reassurance that treatments were safe or effective and urged GPs to oppose it in the consultation, which runs until 2 November.

Sunday, August 16, 2009

Get your omega-3s – carefully

I am really confused about what fish to eat. I hear that fish is good for my health but that some types are healthier and others should be avoided because of contamination. Could you please clarify what fish I should and should not eat?

Fish is a natural source of omega-3 fatty acids, which are thought to have numerous health benefits, including reducing inflammation and the risk of heart disease.

Omega-3 fatty acids may also reduce arthritis, decrease triglycerides, reduce blood clotting and reduce the risk of sudden cardiac death.

Since fish can be good for your health, it is recommended that a person eat up to 12 ounces (two average meals) a week of a variety of fish and shellfish. But which fish should you eat?

To make it easy for you, here are some quick and easy "healthy fish basics":

1. Choose fish that is high in the omega-3s, or the "good fats." Fatty fish from the sea, including salmon, herring, and to a lesser extent tuna, are high in omega-3s. Most freshwater fish have less omega-3 fatty acid than do fatty fish from the ocean.

2. Eat less of the fish that are high in omega-6 fatty acids. Some fish, especially farmed fish like tilapia and catfish, contain more omega-6 than omega-3 fatty acids. This is because farmed fish are often raised on corn-based diets, leading to higher levels of omega-6 and arachidonic acid in their tissues. Arachidonic acid in particular can contribute to inflammation and plaque buildup in your arteries.

3. Avoid contaminated fish: Five primary contaminants are mercury, PCBs, chlordane, dioxin and DDT. Contamination levels increase as they move up the food chain, so remember that the top predators in a food chain – such as largemouth bass or walleye – may have very high levels of chemical contamination. Pregnant and nursing women, as well as children, should especially avoid highly contaminated fish.

Some of the most commonly consumed fish that are low in mercury are shrimp, canned light tuna, salmon and pollock. Conversely, the Food and Drug Administration cautions against eating shark, swordfish, king mackerel or tilefish because they contain high levels of mercury.

4. Think sustainable.

For a complete listing, go to www.montereybay

And finally, if you are a vegetarian, non-fish food options that contain omega-3 fatty acids include flaxseed, flaxseed oil, walnuts, canola oil, soybeans and soybean oil.

Saturday, August 15, 2009

Brazil bans flu medicine ads

Brazil on Friday imposed a temporary ban on all flu medicine advertisements in an effort to reduce self-medication that may disguise A/H1N1 symptoms.

The ban applies to advertisements for aspirin-based medicine and over-the-counter remedies for flu symptoms on all mass media, including the Internet, said the National Health Surveillance Agency (Anvisa).

The measure aims at reducing the self-medication, which may cause errors in the diagnosis of the A/H1N1 flu, leading to more severe cases of the disease, the Anvisa said.

The Brazilian health ministry said that 77 percent of flu cases in the country were A/H1N1 and the number was rising sharply.

Brazil has registered 277 deaths from the disease, the third largest number of A/H1N1 deaths after the United States and Argentina.

Brazil are taking other measures to contain the spread of the A/H1N1virus, such as postponing poliomyelitis immunizations scheduled for Aug. 22 to avoid crowding in hospitals that could lead to more infections.

Classes remain suspended in many schools and universities in the country. Students will have to miss nearly a month of school before most schools resume classes in late August or early September.

Latest data released by the health ministry this week said that there are 3,642 confirmed cases of A/H1N1 flu in Brazil.

However, the ministry noted that the number may grow bigger, as more tests for the disease are underway.

Friday, August 14, 2009

What is alternative medicine?

Acupuncture, chiropractic, naturopathy, homeopathy, diet and supplements all come to mind when you think of alternative medicine.

But, alternative medicine is more than the sum of all the non-medical treatments out there. It is a completely different attitude about health care. Instead of looking for what's wrong, alternative medicine looks for what's right. The focus is on health rather than disease.

When you go to a medical doctor, you may be tested for several possible diseases depending upon your symptoms. An MD is trained to diagnose, before he or she can treat you.

Go to an alternative doctor, and diagnosis is secondary. In fact, alternative practitioners can usually treat without a diagnosis. Unlike surgery and medication, alternative treatments are generally healthful and without risk to the patient.

If this sounds like snake oil to you, you might want to read Never Be Sick Again by San Rafael author Raymond Francis.

A chemist and a graduate of MIT, Raymond Francis was not motivated to take control of his health until he became seriously ill, and near death, at age 48.

Never Be Sick Again is a great introduction to the non-medical approach to health. Francis describes his own transformational journey, and invites the rest of us to follow.

So, curl up with this good book, and discover the world of alternative medicine. And never be sick again.

6 hours of sleep? It's not enough

Scientists have good and bad news for hard-driving people who boast they need only six hours of sleep a night.

The good news is a few may be right: Researchers at the University of California-San Francisco have identified a family with a genetic mutation that causes members to require only six hours sleep a night. The bad news? The gene is vanishingly rare in humans, found in less than 3% of people.

So almost everyone who says he needs only six hours' sleep is kidding himself. And the consequences of chronic sleep deprivation are serious, says Clete Kushida, president of the American Academy of Sleep Medicine and director of Stanford University's Sleep Medicine Center. Sleep deprivation has been linked to an increase in motor vehicle accidents, deficiencies in short-term memory, focus and attention. It's also tied to depressed mood and a decrease in the ability to control appetite.

The family members — a mother and daughter with the gene mutation — were discovered by researchers at UCSF studying circadian rhythms, the waxing and waning biochemical cycles that govern sleep, hunger and activity. Neither woman needed more than six to 6½ hours of sleep a night, and yet both were well-rested, healthy and energetic.

"One of them is over 70, always traveling internationally and extremely active. She dances three or four nights a week," says Ying-Hui Fu, a professor of neurology at UCSF.

When scientists examined the pair's DNA, they found a mutation in a gene called DEC2, which governs cell production and circadian rhythm.

The mutation seems to result in people who need much less than the normal eight to 8½ hours that most humans require for well-rested functioning, according to the paper, which is published in today's edition of the journal Science. The research by Fu and her colleagues determined that humans and mice that carry the mutation get more intense sleep, as measured by slow-wave electrical activity in the brain, and so they need less of it.

But Fu estimates that only about 3% of the population is likely to have this gene and cautions that most people who habitually get less than eight hours sleep a night are only building up a large, and dangerous, sleep debt.

Fu says her lab is investigating whether it might be possible to mimic the effects of the gene with therapeutic compounds, but she cautions the research is only at the very beginning. For now, the only real answer to true productivity is to sleep as much as your body needs, she says.

Can regenerative medicine defeat aging?

The relevance of nearly all biogerontology research to combating aging is restricted to the potential for slowing down the accumulation of molecular and cellular damage that eventually leads to age-related ill-health. Meanwhile, regenerative medicine has been progressing rapidly and is nearing clinical applicability to a wide range of specific conditions. My view is that we are approaching the point where regenerative medicine can be used against aging. This would entail not retarding but actually reversing the accumulation of damage. If successful, this would obviously be a far more valuable technology than mere slowing of aging. However, in order to be successful it must be comprehensive, and some aspects of aging may seem impossible to address in this way. In fact, however, it seems that all types of molecular and cellular damage which contribute to age-related ill-health are realistic targets of regenerative interventions.

The human body is, ultimately, a machine - an astronomically complex machine, of whose workings we remain pitifully ignorant - but still a machine. Like any machine, it accumulates ‘damage’ as a side-effect of its normal operation: molecular and cellular changes that occur throughout life are initially harmless, but eventually (when too abundant) increasingly impede the normal operation of the machine and eventually cause it to fail altogether. Conceptually, there are three strategies to postpone a machine’s demise beyond its ‘warranty period’. First, we can treat it really well throughout its life, thereby slowing down the accumulation of damage: but that can never stop the accumulation altogether, because to do so would require not operating the machine at all, and anyway it cannot address damage that has already occurred. Alternatively, we can combat the late-life symptoms, the dysfunction that eventually emerges: but that too is only a short-term approach, because the underlying damage that causes the dysfunction is still accumulating and making the dysfunction harder and harder to address. This is why the way in which machines that people love are in fact kept in good shape is the third strategy: repair and maintenance, in which we let the damage be created, but repair it before it becomes so severe as to cause dysfunction. In the case of the human body, this means using regenerative medicine against aging.

So… can it work? Are all the types of damage that contributed to age-related ill-health amenable to repair?

People go in for traditional medicines

With no preventive medicines available for swine flu in modern medicine, people are increasingly turning towards the traditional systems of medicines like Ayurveda and homeopathy.

The homeopathic medicine Influnzenium 200 is in great demand these days. A repesentative of Dr Reckweg Clinic in the city said “the medicine has become the most sought after these days after the swine flu menace spread. Earlier, nobody asked for it even once in a day.” Stocks are fast selling out and we have ordered fresh stocks, said a homeopathic medicine shop owner.

Homeopath Tareshwar Jain says swine flu is an influenza-like illness where primary symptoms are very much similar to those of influenza. Thus, one can take Influnzenium 200 as a preventive medicine. However, consulting a doctor will be advisable before self-medication.

Dr Mahesh Sharma, director of the National Institute of Ayurveda, says there is both preventive and curative medicines in traditional medicine. He says as a preventive measure care has to be taken on maintaining cleanliness and proper diet.

He said an OPD will soon start functioning at the institute from next Monday offering free medicines and guidance. “We can treat people with initial symptoms. However, in advanced and complicated cases with symptoms of diarrhoea and bleeding, it is advisable to approach a specialised hospital, “he added.

He says application of either mustard or sesame oil in the nostrils to get relief from cold, besides swallowing two to three tulsi leaves (with out chewing), also help to increase immunity against the virus.

Dr Sharma suggests taking a dose of the boiled water of a teaspoon of turmeric (haldi) black pepper, tulsi leaves, and jeera could be of great help in curing the the respiratory system and immune system from all kinds viral infections and cure for the common cough and cold.

However he suggests “it is better to avoid butter milk (chach) and curd (dahi) during this period. People are advised to take proper diet and those who suffer from constipation should take some remedy as it increases the chances of infection.”

Wednesday, August 12, 2009

New diabetes-related medicines being tested on patients

Four novel approaches to treat type 2 diabetes were discussed at the recent 69th Scientific Sessions of the American Diabetes Association.

All are in stage 3 clinical research trials right now. In other words, real patients are using these new treatments and their progress is being recorded and analyzed.

One treatment of great interest to anyone with diabetes is the possibility of taking insulin by mouth. New approaches have been developed to make this a reality. Until now, any insulin swallowed is damaged by the stomach acids. New discoveries allow the tissues inside the cheek to absorb insulin.

Another new category of anti-diabetic medicines called SGLT-2 inhibitors have been found to reduce blood sugars without the use of insulin. These drugs make the kidneys spill sugar into the urine. This has two potentially beneficial effects. First, it lowers blood sugar levels by helping the body eliminate high sugars faster. Second, the extra calories the sugar represents are lost. This helps the diabetic lose weight. Side effects seem to be minimal. Studies are under way to prove their value and effectiveness.

There is good evidence that the insulin-producing cells of the body are damaged and destroyed by inflammation in type 2 diabetics. That puts it in a similar category with other inflammatory diseases such as rheumatoid arthritis and gout. One new agent being investigated is called interleukin-2 (IL-2) beta receptor antagonist. Studies have shown the receptor plays a significant role in the death of the insulin producing cells. If this killer agent could be blocked, then insulin production would be preserved. Diabetes would be slowed or maybe even stopped.

Another anti-inflammatory agent being studied is Salsalate. Not only might this medication, which is chemically similar to aspirin, be helpful in preventing type 2 diabetes, but it also could protect against the damage to blood vessels so commonly seen in all diabetics. Salsalate is known to slow down overactive inflammatory pathways in type 2 diabetics. There is now good evidence that inflammation of blood vessels is closely associated with insulin resistance and impaired insulin secretion.

None of these medicines will be on shelves anytime soon. It’s important to study new medications for side effects and prove their value. Next, the FDA would need to evaluate these drugs and that process can take time before formal approval. Finally, like any other new medicines, don’t expect them to be inexpensive or covered by your health insurance.

As exciting as any new medicine may seem, the best management for any type of diabetes is carefully balancing food eaten, regular activity, and medications (only if needed). The Diabetes Prevention Program proved more than a decade ago that regular daily exercise combined with improved eating habits aimed at lowering weight by just 7 percent prevents diabetes better than any known medicine.

Obesity medicine becomes a specialty

It’s a disturbing sign of the times that doctors soon will be able to earn certification in obesity management.

USA Today reports that the Obesity Society, the American Diabetes Association, the American Academy of Pediatrics and other groups are combining to create the certification. Doctors will be required to pass tests relating to nutrition, exercise and psychology. In announcing the partnership and certification development, the society cited the 66 percent of adults and 32 percent of youth who are overweight or obese.

Some will no doubt criticize the move as a way for doctors to get more money out of consumers and insurance companies. And yet there’s no way to avoid the reality that the growing obesity epidemic among adults and children contributes to rising health care costs. The severely overweight and obese are susceptible to and suffer from more ailments. Unfortunately, Oklahoma’s a case study.

A recent national report found that Oklahoma has the sixth-highest rate of obese adults. The news wasn’t quite so bad for the 10- to 17-year-old group, which ranked 33rd. State health officials have warned that those statistics are partly why the state has such a high incidence of diabetes and heart disease.

Some patients may indeed benefit from the advice and expertise of an obesity specialist. Others would do well to follow the age-old advice of eating better and exercising more.

Tuesday, August 11, 2009

Alternative medicines can cure swine flu

At a time when swine flu is taking lives across the globe with India being no exception to it, very few know that its sure shot treatment
is hidden in the country itself. The oldest mode of medicine -- Ayurveda has a cure for the much talked about swine flu. While there is panic among people when it comes to the tests and medication of the H1N1 virus, the Ayurveda and Homeopathy experts claim to know methods of prevention and cure of the disease.

In contrast to Allopathy medication being preferred by the apprehensive patients, there are few takers of the ayurveda and the homeopathy medicines even if it claims to provide hundred per cent treatment. Dr Bhagwan Singh, principal and superintendent of State Ayurvedic College, Lucknow, says, "The disease (swine flu) and its treatment is already mentioned in our old books of medicines by sages. On the basis of the symptoms of swine flu, it has been given the name `vatashlesmic' fever in the ayurvedic medicine books."

He further added, "Whenever there is a change in the environment due to spurt in growth of any kind of virus, human beings are the first one to be affected by it. For treating a patient infected with H1N1 virus, ayurvedic medicines like Sanjawini Vati and Tribhuvan Kriti Ras can be given. These medicines are prepared by mixing 12-14 ayurvedic ingredients selected on the basis of the symptoms of the viral disease."

However, it is not only Ayurveda that has a cure for the flu. Homeopathy also claims to have medication for H1N1 treatment. No matter that homeopathic treatment involves a slow process of curing any disease, its practitioners still consider it to be effective in treating swine flu. Dr B N Singh, director of Homeopathy, UP says, "Swine flu is an influenza like illness, where primary symptoms are very much similar to those of influenza. Thus one can take Influnzenium 200 as a preventive medicine. Three doses each after 10 minutes within 24 hours can develop an immunity against H1N1 virus."

"Moreover a combination of 6-7 homeopathic medicines should be given according to the symptoms of the patients. These include Aconite Nap 30, Belladona 30, Bryonia Alb, Mercuris Vibre, Gelsinium 30 and Eupaporium Purf. These medicines should be taken after consulting a homeopathic doctor as they are advised only after examining the patients and his/her symptoms," he added.

He also informed, "Along with the homeopathic medicines one can also take supplements of biochemic medicines like Ferrom Phos 3x and Kali Mure 3x, 2-4 tablets three times a day to prevent getting infected from H1N1 virus.

Monday, August 10, 2009

Immune system cancer found in young 9/11 officers

Researchers say a small number of young law enforcement officers who participated in the World Trade Center rescue and cleanup operation have developed an immune system cancer.

The numbers are tiny, and experts don't know whether there is any link between the illnesses and toxins released during the disaster.

But doctors who coordinated the study, published Monday in the Journal of Occupational and Environmental Medicine, said people who worked at the site should continue to have their health monitored.

"What we are trying to get out there is: Be alert," said Dr. Jacqueline M. Moline, director of the World Trade Center Medical Monitoring and Treatment Program at the Mount Sinai School of Medicine.

The researchers looked at 28,252 emergency responders who spent time amid ground zero dust and found eight cases of multiple myeloma.

Those findings were no surprise. Multiple myeloma is the second most common hematological cancer in the U.S. after non-Hodgkin's lymphoma. Normally, researchers would expect to find about seven cases in a group as large as the one examined in the study.

However, four of the people who fell ill were under age 45, and multiple myeloma is thought to be more rare among people of that age. Under normal circumstances, researchers would have expected to find only one case of the disease in that age group.

Those four young multiple myeloma patients included one officer who was caught in the dust cloud on 9/11 and then spent months working long hours at the site. Another spent 111 days at the Staten Island landfill where the rubble was sifted. Two others had less exposure, working 12 and 14 days each in the pit and rubble pile.

The study said it is possible the monitoring program was simply more effective at finding the illness among people who wouldn't ordinarily be subjected to intense medical tracking.

Nevertheless, Moline said, "You shouldn't be seeing so many cases of myeloma in younger folks." The median age of diagnosis for that cancer in the general public is 71.

Several groups are studying New Yorkers exposed to toxic dust when the skyscrapers collapsed.

To date, no study, including the one published Monday, has established a link between that dust and cancer, said Lorna Thorpe, a deputy commissioner and epidemiologist at New York City's health department.

The timing of the four cases examined by the team at Mount Sinai also raised questions about whether they are related to their work at ground zero, she said.

Most research on multiple myeloma indicates that it usually takes 10 to 20 years for someone to develop that cancer after an environmental exposure to a carcinogen.

In these cases, the cancers were diagnosed in as little as three to four years after the attacks, suggesting that something else caused the disease.

Saturday, August 8, 2009

Oregon College of Oriental Medicine

Ankrom Moisan Associated Architects’ design of the Oregon College of Oriental Medicine’s new campus applies an ancient aesthetic philosophy, feng shui, to a nearly 100-year-old building in Portland’s Old Town/Chinatown neighborhood.

OCOM, founded in Portland in 1983, is one of the first Oriental medicine colleges in the country to offer master’s and doctoral programs in acupuncture and Oriental medicine.

The college will move from its Southeast Portland location into the former Globe Hotel at Northwest Couch Street and First Avenue. The building, constructed in 1911, is four stories tall and contains 35,160 square feet of space. It will be seismically upgraded and fully restored with a 4,330-square-foot rooftop addition.

Ankrom Moisan’s design was adjusted by a feng shui specialist to ensure the college receives positive qi, a Chinese word that describes the active energy forming part of any living thing.

“The director of OCOM hired a man from New York who reviewed the design documents,” Ankrom Moisan principal-in-charge Jeff Hamilton said. “He looked at things like proximity to the river, bridges and parks, and he wrote up a report. We met with the college and our design team, and made changes to the drawing to make the design work better according to principles of feng shui.”

The goal is for the renovation to be certified Leadership in Energy and Environmental Design gold. The rooftop addition will include decks, a green roof and an herb garden. The college facility will include classrooms and administrative offices, as well as an Oriental medical clinic on its fourth floor that will be open to the public six days a week. Active-use and retail spaces on the college’s ground floor will create more viable retail space in the neighborhood. That was important to the Old Town Chinatown Neighborhood Association, Hamilton said.

“The neighborhood association was interested in the streetscape,” he said. “They wanted retail and restaurants, and were interested in who would work on the ground floor of the building, as well as how the building would fit with the University of Oregon building and light-rail line.”

General contractor SD Deacon is expected to begin construction on the renovation at the end of September.

Other project partners include Beam Development, structural engineering firm DCI Engineers and mechanical and electrical engineering company Interface Engineering.

Friday, August 7, 2009

Herbal medicine

Interested in herbal medicine-making? Here are some excellent books as well as local resources to help you.

The Herbal Medicine-Maker's Handbook: a home manual by James Green is an excellent book for the layperson. It has detailed instructions on making a variety of things: from infusions to decoctions, hydrosols to flower essences, ointments to salves and lotions to creams, this book has it all. There are step-by-step instructions, including a list of needed equipment. With definitions of botanical terms and historical highlights, this is a must-have for anyone interested in making their own herbal and skin care products.

Herbal Medicine from the Heart of the Earth by Sharol Tilgner is another good book on medicine-making. While it assumes the reader has some knowledge of herbs, this is more a matter of vocabulary than anything else. Botanical terms occur in abundance; readers without prior herbal education may wish to read with dictionary in hand. Readers with prior herbal education may be frustrated that common names of herbs are the default terms, though the genus species names are included. Whatever the reader's background, the book is helpful and informative.

For those embarking on medicine-making for the first time, hands-on instruction is invaluable. Julie Mitchell, herbalist, is hosting a class at 9:00 AM on August 30th at Eos Botanicals in Monkton. The program will focus on the timely topic of herbal medicines for influenza. There is a small fee for supplies, click the link above for contact information. Purple Shutter Herbs in Winooski also offers classes on medicine-making throughout the year.

If there are things you don't understand, ask clarification from your local herbalist or herb shop. Follow directions, be safe, and enjoy your herbal medicine-making adventures!

Administration weighs flu vaccine options

The Obama administration is considering an unprecedented fall vaccination campaign that could entail giving Americans three flu shots – one to combat annual seasonal influenza and two targeted at the new swine flu virus spreading across the globe.

If enacted, the multibillion-dollar effort would represent the first time Americans have been asked to get more than one flu vaccine in a year, raising serious challenges concerning production, distribution and the ability to track potentially severe side effects.

Another option, said Dale Morse of the Centers for Disease Control and Prevention, is adding an ingredient to target the new virus into the seasonal flu shot.

Experts inside and outside the administration are evaluating a raft of complicated issues, including who should receive an inoculation against the swine flu and whether private vaccine makers can simultaneously manufacture the standard 180 million doses as well as up to 600 million rounds of a new vaccine.

"We are moving forward with making a vaccine," said Robin Robinson, a director with the Department of Health and Human Services who oversees pandemic response programs. Nothing that a formal decision about the swine flu vaccine has not been made, Robinson said that the government would probably produce two doses per person if the decision is made to go ahead. If the threat diminishes, he said, health officials could decide to produce doses for only a portion of the population.

Vaccine and pandemic experts are working with the administration to determine how to produce, test, track and educate the public about two different influenza vaccines in the same flu season.

"They have never tried this before, and there is going to be a great deal of confusion," said William Schaffner, chairman of the Department of Preventive Medicine at Vanderbilt University School of Medicine.

Memories of the nation's earlier experience with a swine flu vaccine present another challenge.

In 1976, hundreds of Americans developed neurological disorders after they were vaccinated for a swine flu strain. The public was asked to receive one of two vaccines developed to combat the strain.

Officials have asked manufacturers to speed production of the seasonal vaccine scheduled for this fall to make way for the possible mass production of a swine flu vaccine.

A decision on whether to produce such a vaccine will have to be made soon, because it typically takes five months to produce a new vaccine and authorities would want it available for the next flu season.

A record-keeping system would also be needed to track which doses patients have received, health experts said.

Thursday, August 6, 2009

Alzheimer's: Where Art Thou?

Placing some sort of GPS tracking device on patients has proven incredibly useful for knowing the whereabouts of patients who are likely to go missing, escape, or wander off and not receive the care they require for their condition. The Alzheimer’s Association reports that in 2009:

* As many as 5.3 million people in the United States are living with Alzheimer’s.
* Alzheimer's and dementia triple healthcare costs for Americans age 65 and older.
* Every 70 seconds, someone develops Alzheimer’s.
* Alzheimer's is the seventh-leading cause of death.
* The direct and indirect costs of Alzheimer's and other dementias to Medicare, Medicaid and businesses amount to more than $148 billion each year.

There are many GPS devices marketed to both care givers and medical professionals. A higher degree of sophistication has led to more thoughtful ergonomic designs and a wider range of tracking and reporting capabilities. Both RFID and GPS have provided solutions, with GPS having a definite advantage in its ability to locate without regard to specialized receivers found in RFID systems.

Current emphasis on designs are for bracelet and belt devices, special placement in clothing, and newly introduced GPS-equipped shoes. The challenge for this disease is securing the device to be nonobtrusive and affixed to a patient without his or her ability to remove it. Digital Angel was an early pioneer in this space, with the more recent Columbia medical bracelet becoming available in the U.S. The Columba is monitored via Assisted GPS and has a GSM/GPRS transmitter/receiver with a SIM card for voice and data.

Finding “Ground Zero” of Asthma Causes

Asthma Researcher leader David van Sickle, a Robert Wood Johnson Foundation Health and Society Scholar and a former disease detective in the Epidemic Intelligence Service at the Centers for Disease Control and Prevention (CDC) in Atlanta, leads the drive to map asthma sources.

“For the millions of chronic asthma patients, knowing the ‘where’ indicates the ‘what,’ which provides important clues in individual and epidemic out breaks of asthma attacks. Sufferers are treated with a blanket of probable treatments with out indication of what exactly triggered the condition. Research is under way to develop a GPS inhaler that records the position or onslaught of an attack.” Van Sickle’s goal is to map where and when environmental exposures trigger asthma symptoms, prompting them to puff on their “rescue” inhalers, which deliver the medicine that keeps them breathing.

t’s easy to predict problems when an asthmatic visits a “cat lady” or runs through a field of ragweed. But van Sickle plans to use global positioning technology to find previously unknown causes of the lung disease and help doctors better monitor whether treatment is controlling symptoms and improving quality of life. A dramatic example includes an epidemic outbreak of asthma attacks in Barcelona that overwhelmed hospitals and emergency centers. “An epidemic of severe asthma struck Barcelona throughout the 1980s,” van Sickle said. “On more than 20 days, emergency rooms were overwhelmed with people having severe, and sometimes fatal, asthma attacks. Barcelona put together a group of scientists to look at the meteorology, climatology, and levels of standard air pollutants and pollens in the city, but there wasn’t anything exceptional about those days.”

Finally, they asked where the patients had been when they got sick: All reported that their symptoms started near the waterfront. Further investigation showed that the port had been unloading giant heaps of soybeans from container ships. “The victims were exposed to massive clouds of soybean dust because the appropriate filters weren’t installed in harbor silos,’’ he says. “It took the group nearly eight years to prove, but it was the first time soybean dust had been shown to be a potent allergen.”

Obama's secret plan to socialize medicine

So now some folks aiming to kill the president's health care plan are trying out a new tactic. Let me state again: I am undecided on the health plan. I am leaning against it because I see no way to pay for the public option part of it, and it does nothing to control the costs of Medicare or Medicaid.

But I would rather see us debate those policy points than to create strawman arguments just to shoot them down. And that seems to be the new tactic on the right. I've heard this from readers, and this morning, I heard the same line of argument from Sen. Jim Demint on CNN. He even referenced the same YouTube video a reader sent me. Here's how the argument goes: Obama has admitted to wanting a single-payer system that would replace all private insurance -- that's his true goal!

Well, when cornered on this issue by Hillary Clinton, Obama did talk a lot on the campaign trail about universal health care. Remember the debate? Was his plan REALLY universal health care? No matter, in the current debate, there is no proposal that would create a single-payer system.

But here's the irony. The far left is saying much of the same thing. They are saying that Obama got elected as a proponent of a single-payer system. Obama's own doctor is in this camp. They argue he has a mandate for such drastic reform, and they don't understand why he is giving in so much to the moderate middle.

So the far left and the far right agree: We elected a man who, if he really got his way, would create a single-payer system. What's more, he vowed to make this a top priority.

Um, folks on the right -- is that really the point you want to make? Remember, his victory wasn't exactly a nail-biter.

Health Science Center’s nuclear medicine program earns accreditation

The University of Texas Health Science Center at San Antonio says its program that trains resident physicians in nuclear medicine has accredited through 2014 by the Accreditation Council for Graduate Medical Education.

Health Science Center officials say the program received an exemplary rating from the council, which oversees the accreditation of post-medical doctor training programs in the United States.

The Nuclear Medicine Residency Program is part of the Health Science Center’s Department of Radiology at its School of Medicine. Its training curriculum is integrated with the San Antonio Uniformed Services Health Education Consortium, which trains military physicians in nuclear medicine.

Nuclear medicine refers to imaging and procedures, such as positron emission tomography (PET) and radiotherapy, that use radioactive material to diagnose and treat a host of diseases, including cancer.

The local residency program trains a maximum of four nuclear medicine residents. This rigorous three-year program is one of 57 ACGME-accredited residency programs that will train more than 700 residents nationwide this academic year.

Darlene Metter, professor and vice chair of clinical education in the Department of Radiology, directs the Nuclear Medicine Residency Program. Metter has been instrumental in the program’s design and implementation at participating sites including Brooke Army Medical Center, Wilford Hall Medical Center, University Health System and the Texas Cancer Clinic.

The Health Science Center is the leading research institution for San Antonio and South Texas. It is one of the major health sciences universities in the world.

Wednesday, August 5, 2009

Using herbal medicine to treat illnesses

Herbal medicine has been successful in treating illnesses in animals and people throughout the years and can be compared to folk medicine in many cultures. Wild animals are though to instinctively know the proper herbs when sick. A program called the Hoxsey Program was originated by a man who observed which herbs were eaten by animals under the conditions of certain diseases.

The scientific research on using herbs is about where vitamins were 10 years ago. Many companies don't want to invest in expensive research because most herbs lack the ability to be patented, nor are they under a FDA regulation as drugs and medications typically are.

Many modern pharmaceutical drugs are compounds considered to be active ingredients in herbs. Herbalists defend that the pharmaceutical ingredients and the whole plant are not the same due to unique and complex properties of the original substances.

It can be difficult to find fresh herbs that are pleasant tasting to dogs. Herb combinations have been developed for certain syndromes and made into pills or capsules. They can be obtained from many herbal companies and are generally classified as Western Herbs or Chinese Herbs. Chinese combinations have been around for centuries and have a long record.

As with any change in your dog's regimen, keep your vet informed regarding the medications, herbs, and supplements your pet may be taking. Some of these can interfere with the absorption or action of another. And remember if herbs are natural doesn't mean they can't cause adverse effects if used inappropriately.

New Strain of H.I.V.

European scientists have discovered a new strain of the virus that causes AIDS and linked it to gorillas, creating a mystery about when and how the first patient found to have the strain became infected.

It is thought to be likely that this is the first time scientists have documented the jump of a simian immunodeficiency virus to humans from a gorilla. All three other known strains of the human immunodeficiency virus, H.I.V.-1, have been linked to chimpanzees. But genetic tests showed that the new virus was closely related to a recently recognized gorilla virus.

The most likely explanation for the new virus’s emergence is gorilla-to-human transmission, probably a result of humans slaughtering apes or handling or eating their meat.

But the scientists said they could not dismiss the possibility that the chimpanzee virus linked to H.I.V.-1 was transmitted to gorillas and then to humans, or was directly transmitted to humans and then to gorillas.

The new virus strain was isolated in 2004 from a 62-year-old woman upon her arrival in Paris from Cameroon in West Africa. She has not been treated for AIDS and has no signs of the syndrome, the scientists said.

The woman had lost weight in 2003 and had been ill with a fever a number of times, the scientists said in reporting the discovery, in the Aug. 2 issue of the journal Nature Medicine.

Her husband died in 1984 from complications of a stroke. It is not known if he was infected with H.I.V. The woman had six children, all born before 1980, a year before doctors first recognized AIDS; two of the children died of noninfectious causes, and none of the surviving children have H.I.V.

The authors of the report said they presumed that she had been infected through sex. The woman told her doctors that she had sexual partners in Cameroon after her husband’s death, but there was no information about whether any were infected — or, if they were, how they had contracted the virus.

The new virus may escape detection by standard blood and laboratory tests for H.I.V.-1. New testing methods developed in recent years have allowed scientists to detect subtypes of H.I.V.-1. The three others are known as H.I.V.-1 Groups M, N and O. Dr. Plantier’s team calls the new one H.I.V.-1 Group P.

Tuesday, August 4, 2009

Athletic Training and Sports Medicine

The K-State Athletic Department places a top priority on helping its student-athletes to reach and maintain their best health and achieve their conditioning goals. Because of this, K-State has developed excellent training and conditioning programs to help prevent injuries and insure safe practice and competition habits. However, if injuries do occur, the department is prepared to implement a comprehensive rehabilitation program.

At Kansas State, the Certified Athletic Trainers are highly educated and skilled professionals specializing in athletic health care. In cooperation with physicians and other allied health personnel, the athletic trainers function as integral members of the athletic health care team.

Certified athletic trainers have, at minimum, a bachelor's degree, usually in athletic training, health, physical education or exercise science. In addition, athletic trainers study human anatomy, human physiology, biomechanics, exercise physiology, athletic training, nutrition and psychology/counseling. Certified athletic trainers also participate in extensive clinical affiliations with athletic teams under appropriate supervision.

In addition, Certified Athletic Trainers are required to obtain 75 hours worth of Continuing Education Units (CEUs) within a three year period to remain in good standing. These CEUs, which are obtained from attending conferences, lectures, presentations, etc..., assist Certified Athletic Trainers in expanding their knowledge and training in the ever-changing world of medicine and rehabilitative therapy.

Certified athletic trainers have fulfilled the requirements for certification established by the National Athletic Trainers' Association Board of Certification, Inc. (NATABOC). The certification examination administered by NATABOC consists of a written portion with multiple choice questions; a practical section that evaluates the skill components of the domains within athletic training; and a written simulation test, consisting of athletic training related situations designed to approximate real-life decision making. This last portion of the test evaluates athletic trainers' ability to resolve cases similar to those they might encounter in actual practice.

The examination covers a variety of topics within the six practice domains of athletic training: Prevention Recognition, Evaluation and Assessment Immediate Care Treatment, Rehabilitation and Reconditioning Organization and Administration Professional Development and Responsibility. Once athletic trainers pass the certification examination proving skills and knowledge within each of the six domains, they use the designation "ATC" or "CAT."

Female Athletic Trainers
Although athletic training was once considered a male-dominated profession, more than 50% of all members of the National Athletic Trainers' Association are women. As of January 1990, more than half of the athletic trainers certified by the NATABOC have been women.

National Athletic Trainers' Association
The National Athletic Trainers' Association (NATA) is a not-for-profit organization dedicated to improving the health and well-being of athletes worldwide. The Association is committed to the advancement, encouragement and improvement of the athletic training profession. Founded in 1950 with a membership of 200 athletic trainers, the NATA today has more than 30,000 members worldwide. Approximately 92 percent of all certified athletic trainers in the country belong to the Association. In 1990, the American Medical Association recognized athletic training as an allied health profession. The Association sets the standards for athletic trainers through its education programs. Almost 100 universities and colleges offer NATA-approved curricula. Based in Dallas, Texas, the organization provides a variety of services to its membership including continuing education, governmental affairs, certification and public relations. The NATA also publishes the Journal of Athletic Training, a quarterly scientific journal; and NATA News, a monthly news magazine.

Monday, August 3, 2009

Beware of socialized medicine

You baby boomers are too young to remember the problems the UK had with their socialized medicine. During World War II, I worked on a farm as an early teenager and then Winston Churchill, who brought England through the war, was tossed out of office like a broken piece of furniture. The Socialist Clement Atlee instituted socialized medicine.

Britain gave up its empire and gave freedom to all of its former colonies to pay the huge bill for free medical care. The cost was so great that no new hospitals would be built for almost 20 years. People flocked to doctors' offices and then threw the prescriptions into a trash barrel outside the office if they didn't like what the doctor prescribed. Winston Churchill fell and broke his hip and had to wait six days before he could be taken to a bed in the hospital. Since the doctors were on a salary and worked only eight hours, they walked out of the operating room at the end of their shift and were replaced by the relief shift, much to the detriment of the patient. There was no choice of physicians and if you did not like the one you were assigned, it was against the law to pay another doctor to see you, if you were lucky enough to find one.

Other countries went the same direction in socialized medicine, and in Sweden, doctors were not allowed name tags on their coats because it discriminated against orderlies who demanded the same status. In other words, socialism put all participants on the same stage of importance. Having been awarded my medical degree in 1963, I have lived through the full spectrum of medical care and took care of welfare patients before Medicare and Medicaid were enacted in 1965 and put into action in 1966. From that point on, there has been a progressive erosion of the medical profession as government power brokers seek control of the healing arts.

All New Natural Medicine

A Cure for the "Sorry State of American Health!" Radhia Gleis, CCN, President of Advanced Health Institute, Has Just Launched a Newly Redesigned and Re-Branded Interactive website for This Austin Based Company

AUSTIN, Texas, Aug. 3, 2009 (GLOBE NEWSWIRE) -- The title quoted above, from the cover story of the December 1, 2008 issue of Time, says it all, says Radhia: our nation's health care system is not meeting the needs of its citizens. Despite the trillion-dollar level of expenditures on conventional health care over the last century, the primary metrics which gauge U.S. health care system effectiveness show no progress in eliminating diet and lifestyle-related illnesses over the last century. While we have been somewhat successful in combating communicable diseases, it is clear that we have been singularly unsuccessful in effectively combating the rapid rise, persistence and proliferation of diet and lifestyle-related diseases as the leading causes of death over the same period. The phrase "health care system" is a misnomer. This is actually a "disease management system" and until we address the underlining causes of disease we will never find the cure to what ails us, no matter how much money we throw at it.

"We have to go back to the basics," says Radhia, "and our new website can assist the natural health care seeker in finding the answers to their individual wellness challenges."

"We are excited to be launching our new website and new brand. Our new look is amazing and designed to make your natural health care education and services easy to navigate, and interact. The rebrand is our launching pad into a new era of innovation, with many new education features and direct interaction with the nutritionist." The website design features short video formats, and online assessment tools which allow you to target your specific needs and interact with Radhia personally. Continual updates and ongoing educational videos and articles keep you informed as to the latest cutting edge technology in the field of natural health.

Saturday, August 1, 2009

Red yeast 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.

Plastic Surgery: Medicine or Marketing?

Plastic surgery was once reserved for the wealthy elite, who were careful to keep their occasional nip tucks hush hush. Today, reality shows, celebrity exposés, and provocative websites have brought cosmetic surgery out into the open. Some say that all this media exposure raises consumer awareness, while others argue that objective information is drowned out by so much marketing hype.

A generation ago, plastic surgery was reserved for the uber-wealthy, who kept a low profile when they went under the knife. Hollywood starlets were closely guarded during surreptitious trips to the surgeon, and trophy wives disappeared for mysterious “spa treatments”, emerging weeks later looking far more than refreshed.

Today, plastic surgery is seemingly everywhere. From television reality shows, prime time dramas and medical before-and-after series to a barrage of websites that let consumers see themselves in 3-D, rate their surgeon, or pander for benefactors to pay for their breast implants, the media can’t get enough of cosmetic surgery.

In the latest episode of Plastic Surgery Talk, host Dr. William P. Adams, Jr., MD, talks with board certified plastic surgeon Dr. Brett Snyder, MD about the media’s obsession with plastic surgery. Is the media’s fixation merely a reflection of the industry growth, particularly among middle class Americans? Are consumers better informed because of the extensive coverage, or are they falling prey to the marketing hype? Dr. Snyder shares some surprising insights during the show.