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"Hop up on the table, Honey." mThat's how an x-ray technician addressed my 89-year-old mother-in-law in 2001, when we took her for knee x-rays. Mom, who had advanced osteoporosis and arthritis as well as confusion and heart problems, had long since given up hopping. When it became obvious that she needed assistance, the technician grabbed her arm -- as if pulling on another sore appendage would magically raise the rest of her onto the table. It didn't. This incident has become our personal mantra for expressing what is wrong with America's health care system. Having helped our four parents during their final years and having both had cancer ourselves as well as other medical problems, we have had experiences with five nursing homes, two personal care facilities and a half dozen hospitals. We've lost count of the doctors, drugstores and health insurance plans. All of us have had health insurance, though some policies were better than others. Nonetheless, we have experienced incident after incident demonstrating the waste, ignorance and apathy which is rampant in the system. Unable to list them all, I have been heretofore reluctant to write about a handful of them lest the reader be persuaded that the problem is with only that hospital, only that nursing home or only that doctor. There is, however, an increasing crisis of confusion, mismanagement and ill-preparedness which is at the core of our healthcare system. We are all familiar at least with the trend line if not the specifics for healthcare costs. According to WhiteHouse.gov, "The United States spends over $2.2 trillion on health care each year-almost $8,000 per person." That's sixteen percent of the economy. Healthcare costs are projected to increase to almost twenty percent ($4 trillion a year) by 2017. Meanwhile forty-six million Americans are without health insurance (14,000 more each day), premiums and co-pays are rising and more reasons are used to refuse coverage both to those willing to pay and thos

"Hop up on the table, Honey." mThat's how an x-ray technician addressed my 89-year-old mother-in-law in 2001, when we took her for knee x-rays. Mom, who had advanced osteoporosis and arthritis as well as confusion and heart problems, had long since given up hopping. When it became obvious that she needed assistance, the technician grabbed her arm -- as if pulling on another sore appendage would magically raise the rest of her onto the table. It didn't. This incident has become our personal mantra for expressing what is wrong with America's health care system. Having helped our four parents during their final years and having both had cancer ourselves as well as other medical problems, we have had experiences with five nursing homes, two personal care facilities and a half dozen hospitals. We've lost count of the doctors, drugstores and health insurance plans. All of us have had health insurance, though some policies were better than others. Nonetheless, we have experienced incident after incident demonstrating the waste, ignorance and apathy which is rampant in the system. Unable to list them all, I have been heretofore reluctant to write about a handful of them lest the reader be persuaded that the problem is with only that hospital, only that nursing home or only that doctor. There is, however, an increasing crisis of confusion, mismanagement and ill-preparedness which is at the core of our healthcare system. We are all familiar at least with the trend line if not the specifics for healthcare costs. According to WhiteHouse.gov, "The United States spends over $2.2 trillion on health care each year-almost $8,000 per person." That's sixteen percent of the economy. Healthcare costs are projected to increase to almost twenty percent ($4 trillion a year) by 2017. Meanwhile forty-six million Americans are without health insurance (14,000 more each day), premiums and co-pays are rising and more reasons are used to refuse coverage both to those willing to pay and thos

Medicine has increased the ranks of the elderly. Can it make old age any easier? The job of any doctor, Bludau later told me, is to support quality of life, by which he meant two things: as much freedom from the ravages of disease as possible, and the retention of enough function for active engagement in the world. Most doctors treat disease, and figure that the rest will take care of itself. And if it doesn't-if a patient is becoming infirm and heading toward a nursing home-well, that isn't really a medical problem, is it?

*In West Chester, Community Volunteers in Medicine treated 332 patients in February, up 26% from February 2008. The cost of care was up 21%. At the same time, the clinic was about $100,000 behind in fundraising for its $1.8 million annual budget. *Ohio's 40 free clinics treated 56,000 uninsured patients in 2008, up from 43,000 in 2007. Marjorie Frazier, executive director of the Ohio Association of Free Clinics, expects the number to increase in 2009. In January, one clinic in Cleveland closed because it lacked funding. Ohio, one of the few states that helps pay for free clinics' operations, is cutting funding. Its two-year allocation for 2008 and 2009 was $2.1 million; for 2010 and 2011, proposed funding is $1.5 million. *California's 800 community health centers saw increases of up to 20% in uninsured patients in the past six months. The state, facing a $42 billion budget shortfall, is eliminating payments for some services for poor adults, including dental care. As a result, the centers will lay off 1,000 dentists and other staff, leaving as many as 400,000 people without dental care, says Chris Patterson, spokesman for the California Primary Care Association.

Participatory medicine will owe part of its success to the technologies that have the potential to remove treatment, symptom management, administrative, and communications burdens from individuals and clinicians while maintaining the critical interpersonal interactions between them. Out of the steady stream of new devices, programs, gadgets, and applications, which will make a difference in the health and lives of patients? We hope to build the Journal as a resource for critical reviews of technologies that support and facilitate participatory medicine. We realize it will be no small undertaking to put together a process that will allow for the review of a substantial number of technologies over time, reflecting the experience of different types of users.

The precise mechanism of the anti-tumor effect of imiquimod in BCC is not known. It has been postulated that ultraviolet radiation induces mutations in the tumor-suppressor genes and alters the immuno-surveillance, so that tumor cells escape from cytotoxic T cells and apoptosis.[1] Th-2 cytokines, that downregulate tumor surveillance, are raised in BCC.[1],[5] Imiquimod acts on toll-like receptor-7 (TLR-7) present on dendritic cells, macrophages and monocytes and induces expression of interferons, Th-1 cytokines (IL-1, IL-6, IL-10 and IL-12), tumor necrosis factor-a and G-CSF, thereby counteracting Th2 cytokines and promoting tumor surveillance.[1],[5] It also enhances the activity of natural killer cells and epidermal Langerhans' cells. The tumor regression is achieved probably by induction of Fas receptors on the tumor cells resulting in their apoptosis.[10]

In every industrialized nation, the movement to reform health care has begun with stories about cruelty. The Canadians had stories like the 1946 Toronto Globe and Mail report of a woman in labor who was refused help by three successive physicians, apparently because of her inability to pay. In Australia, a 1954 letter published in the Sydney Morning Herald sought help for a young woman who had lung disease. She couldn't afford to refill her oxygen tank, and had been forced to ration her intake "to a point where she is on the borderline of death." In Britain, George Bernard Shaw was at a London hospital visiting an eminent physician when an assistant came in to report that a sick man had arrived requesting treatment. "Is he worth it?" the physician asked. It was the normality of the question that shocked Shaw and prompted his scathing and influential 1906 play, "The Doctor's Dilemma." The British health system, he charged, was "a conspiracy to exploit popular credulity and human suffering."

It was concluded that omega-3 fatty acid could inhibit the proliferation of pancreatic cancer cell line SW1990 cells and promote their apoptosis. The down-regulation of the cyclin E expression by omega-3 fatty acid might be one of the mechanisms for its anti-tumor effect on pancreatic cancer. \n\nModulatory effects of EPA and DHA on proliferation and apoptosis of pancreatic cancer cells.\nZhang W, Long Y, Zhang J, Wang C.\nJ Huazhong Univ Sci Technolog Med Sci. 2007 Oct;27(5):547-50.\nPMID: 18060632

A Senate panel has until Sept. 15 to deliver a bipartisan healthcare overhaul package before Democratic leaders take steps to push a bill without broad Republican support, a senior member of the Finance Committee said. Sen. Charles Schumer (D-N.Y.), vice chairman of the Democratic Conference, said that the party has "contingencies in place" that would make it highly likely a bill could pass the Senate without GOP votes, but warned such mechanisms would be used as a "last resort." "Healthcare reform is just too important," he said, adding that it can't be left to "wither on the vine."

Resveratol, found in red wine (etc.) stimulates the SIRT1 gene, which is linked to extended health + lifespan in rodents. Sitris was able to replicate those results in humans. The resveratol formula stimulates the same gene that 'calorie-restricted' diets do. Sitris also found it reduces blood glucose in diabetic patients...But small trial, short duration...

Skinner JS, Staiger DO, Fisher ES. Is technological change in medicine always worth it? The case of acute myocardial infarction. Health Aff (Millwood) 2006;25:w34-w47.

The AARP just met with the leadership of the Mayo Clinic, one of the most outstanding medical institutions in the country. They provide excellent care at a cost that is less than most other parts of the healthcare system - and with improved outcomes. We asked them about their secret to success.\n\nMayo has an electronic medical record and all their patients have their information online. The physicians are on salary, so there's no incentive to order unnecessary tests or procedures, and Mayo has an ethic of patient-centered care, with a long history of attracting the best people and rewarding them.\n\nIf Mayo can do it, why can't everyone else? The AARP believes that the potential is there for most communities to have excellent care - we must emulate the care delivery of institutions like the Mayo Clinic, and put in place payment and information systems that will coordinate care management better. It's a big job and will take some investment, but we have many opportunities to do a better job than we're doing today.

This article elaborates the necessity to quit smoking with support from relevant data. While it also states the reason for which a person finds quitting to smoke so difficult, at the same time it also explains why Champix can help you to revive from the situation, effectively.

The fact that an increasing number of medications are unable to beat sugar pills has thrown the industry into crisis. It's not that the old meds are getting weaker, drug developers say. It's as if the placebo effect is somehow getting stronger. Why are inert pills suddenly overwhelming promising new drugs and established medicines alike? Pharma doesn't know, and drugmakers are realizing they need to fully understand the mechanisms behind it so they can design trials that differentiate more clearly between the beneficial effects of their products and the body's innate ability to heal itself. special task force of the Foundation for the National Institutes of Health is seeking to stem the crisis by quietly undertaking one of the most ambitious data-sharing efforts in the history of the drug industry.

What is the future of peer review? Why is there fraud in science? Is plagiarism out of control? Why do scientists do bad things? Is it all a case of:"All that is necessary for the triumph of evil is that good men do nothing?"

Jonathan D. Smith, Department of Cell Biology, NC10, Cleveland Clinic, 9500 Euclid Avenue, Cleveland OH 44195. E-mail smithj4@ccf.org -----     -----     -----     ----- HDL-cholesterol is the "good cholesterol" because of its reverse cholesterol transport and antiinflammatory activities. However, HDL and apolipoprotein A-I can lose their protective activities through changes in protein or lipid composition as well as protein modifications. Assays for dysfunctional HDL could potentially be used as a criterion for preventative therapy.

Vitamin D, nervous system and aging.\nP. Tuohimaa, T. Keisala, A. Minasyan, J. Cachat and A. Kalueff. .\nPsychoneuroendocrinology, Volume 34, Supplement 1, December 2009, Pages S278-S286\n NEUROACTIVE STEROIDS: EFFECTS and MECHANISMS ofACTION\n \n\nReview of vitamin D3, its active metabolites, and their functioning in the central nervous system (CNS), especially in relation to nervous system pathologies and aging. The vitamin D3 endocrine system consists of 3 active calcipherol hormones: calcidiol (25OHD3), 1α-calcitriol (1α,25(OH)2D3) and 24-calcitriol (24,25(OH)2D3). The impact of the calcipherol hormone system on aging, health and disease is discussed. Low serum calcidiol concentrations are associated with an increased risk of several chronic diseases including osteoporosis, cancer, diabetes, autoimmune disorders, hypertension, atherosclerosis, and muscle weakness ~ all of which can be considered aging-related diseases. The relationship of many of these diseases and aging-related changes in physiology show a U-shaped response curve to serum calcidiol concentrations. Clinical data suggest that vitamin D3 insufficiency is associated with an increased risk of several CNS diseases, including multiple sclerosis, Alzheimers, Parkinsons, seasonal affective disorder (SAD), and schizophrenia. In line with this, recent animal and human studies suggest that vitamin D insufficiency is associated with abnormal development and functioning of the CNS. * Overall, imbalances in the calcipherol system appear to cause abnormal function, including premature aging, of the CNS. *

There is reasonable evidence that the use of imiquimod for small (<2 cm) superficial BCC that occur other than on the face provides outcomes only marginally less satisfactory than surgery. There would be a place for imiquimod in treating patients with frequent multiple primary lesions when access to surgery is difficult or where clinical judgment may be influenced by patient factors as reported in some of the studies, eg, where patients may have contraindications to surgery.  It was noted that if recurrences occurred in this study they mostly occurred during the first 9 months after the end of treatment. The initial response was therefore predictive of long-term outcome so these authors recommend and encourage continued monitoring of skin lesions.

Percutaneous coronary intervention (PCI) can often be deferred in patients with stable coronary artery disease (CAD) and significant coronary lesions without adding risk while optimal medical therapy (OMT) is given a chance to work, and it can be consider