Group items tagged

"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

"More than three-quarters of healthcare executives believe their industry's most valuable asset is going to be information contained in electronic medical records...hundreds of billions of gigabytes of health and medical information will be industry's most valuable asset in 5 years. The value, however, must be unlocked by finding ways to overcome a lack of standards, privacy concerns, and technology limitations that could hinder use of the data." || NOTE: This data has already been used by private medical insurance companies to dig up "preexisting conditions" that allow them to drop coverage (rescission) on potentially unprofitable subscribers. ||

Natural Standard Herbal Pharmacotherapy: An Evidence-Based Approach is now available for purchase. The book provides practical guidance on the use of herbal therapies for medical conditions. This reference tool will be an essential part of herbal pharmacy core curricula for all healthcare disciplines. Chapters are organized by medical condition and present supportive evidence, including potential mechanisms of action and dosing, for selected herbal therapies. The chapters also include integrative therapy plans to help clinicians quickly assess patient needs and create cohesive treatment plans. In addition, adjunct therapies, including herbs, supplements and modalities, that are commonly used in combination with primary treatments are discussed. Case studies, which summarize efficacy, safety, dosing and interactions for high-utilization products, help prepare healthcare providers for patient counseling in clinical practice. Review questions, similar to those on national board exams, allow readers to evaluate their learning and identify areas for further study. The book also includes several appendices, which provide information about lab values as well as the safety, interactions and pharmacokinetics of select herbs.

Multiple Clinical Data Presentations at EuroPCR 2008 Support Use of OrbusNeich's Genous(TM) Bio-engineered R stent(TM) as Safe Alternative to Drug-Eluting Stents (Randomized TRIAS HR Pilot Study)

Evidence-Based Research: a series of tutorials for medical and healthcare professionals and students wanting to improve their skills in conducting research geared toward clinical use, this 12-month session is offered by the Journal Club. In addition to the tutorials, you will gain full-text access to all journals in the library at the University of Bridgeport. Only $225 for all tutorials, and for a full year of full-text access to all of the library's digital resources!

Evidence-Based Research: a series of tutorials for medical and healthcare professionals and students wanting to improve their skills in conducting research geared toward clinical use, this 12-month session is offered by the University of Bridgeport's Journal Club. In addition to the tutorials, you will gain full-text access to all journals in the UB library. Only $225 for all tutorials and one year of full-text access to all of the library's digital resources!

Does evidence support use of L-carnitine for angina pectoris? If so, what is the optimal daily dose? // Gayle Nicholas Scott, PharmD Assistant Professor, Eastern Virginia Medical School, Norfolk, Virginia

"There are very few large, well-designed human studies testing the health effects of DHEA supplements. For example, there is not enough scientific evidence to rate the effectiveness of DHEA supplements in treating adrenal insufficiency, metabolic syndrome, depression, HIV/AIDS, Addison's disease, chronic fatigue syndrome, menopausal symptoms, heart disease, breast cancer, infertility, diabetes, or Parkinson's disease according to the National Institutes of Health (NIH). In addition, there isn't enough evidence to support the use of DHEA supplements as an anti-aging remedy or weight-loss aid. The NIH also cautions that DHEA supplements appear to be ineffective for boosting libido, enhancing muscle strength in elderly people, protecting against Alzheimer's disease and improving thinking in healthy older people."

"The American Psychiatric Association (APA) practice guidelines are developed by expert work groups using an explicit methodology that includes rigorous review of available evidence, broad peer review of iterative drafts, and formal approval by the APA"

Journal of Participatory Medicine JPM will be a peer reviewed journal published exclusively in an online journal format, using Open Journal Systems, an open source journal management and publishing system developed by the Public Knowledge Project.

Diosmin is a naturally occurring flavonoid glycoside that can be isolated from various plant sources or derived from the flavonoid hesperidin. # Diosmin is considered to be a vascular-protecting agent used to treat chronic venous insufficiency, hemorrhoids, lymphedema, and varicose veins. As a flavonoid, diosmin also exhibits anti-inflammatory, free-radical scavenging, and antimutagenic properties.

New findings in rodents and human brain shed light on the mechanisms of major depressive disorder (MDD), uncovering over-expression of MKP-1 (mitogen-activated protein kinase [MAPK] phosphatase-1)...and identifying a new therapeutic target. MKP-1, also known as dual-specificity phosphatase-1 (DUSP1), is a member of a family of proteins that dephosphorylate both threonine and tyrosine residues and thereby serves as a key negative regulator of the MAPK cascade4, a major signaling pathway involved in neuronal plasticity, function and survival This study identifies MKP-1 as a key factor in MDD pathophysiology, and as a new target for therapeutic interventions.f Here we use whole-genome expression profiling of postmortem tissue and show significantly increased expression of mitogen-activated protein kinase (MAPK) phosphatase-1 (MKP-1, encoded by DUSP1, but hereafter called MKP-1) in the hippocampal subfields of subjects with MDD compared to matched controls. MKP-1, also known as dual-specificity phosphatase-1 (DUSP1), is a member of a family of proteins that dephosphorylate both threonine and tyrosine residues and thereby serves as a key negative regulator of the MAPK cascade4, a major signaling pathway involved in neuronal plasticity, function and survival. We tested the role of altered MKP-1 expression in rat and mouse models of depression and found that increased hippocampal MKP-1 expression, as a result of stress or viral-mediated gene transfer, causes depressive behaviors. Conversely, chronic antidepressant treatment normalizes stress-induced MKP-1 expression and behavior, and mice lacking MKP-1 are resilient to stress. These postmortem and preclinical studies identify MKP-1 as a key factor in MDD pathophysiology and as a new target for therapeutic interventions.

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.

"Lancet 2010: There is a U-shaped relationship between glycated hemoglobin (HbA1c) levels and mortality in people with diabetes, say researchers, meaning that intensive glucose-lowering therapy could be as harmful as uncontrolled hyperglycemia.\n\nWriting in The Lancet, Craig Currie and team (Cardiff University, UK) conclude that if their findings are confirmed, then diabetes guidelines may need to be revised to include a lower as well as an upper HbA1c threshold.\n\nCurrie's team used the UK General Practice Research Database from November 1986 to November 2008 to obtain data on two cohorts of patients aged 50 years and older with Type 2 diabetes.\n\nThe patients comprised 27,965 individuals whose treatment had been intensified from oral monotherapy to combination therapy with oral blood-glucose lowering agents, and 20,005 who had changed to insulin-containing regimens."

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.\nSiri--Tirino, et al.; \nAm J Clin Nutrition; 2010 Jan 13. \nPMID: 20071648\ndoi:10.3945/ajcn.2009.27725\n\nConclusions: A meta-analysis of prospective epidemiologic studies showed that there is NO significant evidence that dietary saturated fat is associated with increased risk for CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat

Raasch B. Clinical, Cosmetic and Investigational Dermatology. 9 June 2009.  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 t

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.

Prognosis (Outlook) The rate of basal cell skin cancer returning is about 1% with Mohs surgery, and up to 10% for other forms of treatment. Smaller basal cell carcinomas are less likely to come back than larger ones. Basal cell carcinoma rarely spreads to other parts of the body. You should follow-up with your doctor as recommended and regularly examine your skin once a month, using a mirror to check hard-to-see places. Call your doctor if you notice any suspicious skin changes.

Rader also believes that the MEGA trial raises important questions about just how widespread the use of statin therapy should be in primary prevention...reignite discussion on over-the-counter low-dose statins.

In the world of medicine, "key opinion leader" is the somewhat Orwellian term used to describe the senior doctors who help drug companies sell drugs. : BMJ : British Medical Journal