deandouglers: February 2013

Thursday, February 28, 2013

One thousand patients with primary myelofibrosis: The Mayo Clinic experience

Ayalew Tefferi, M.D., with the Department of Hematology at Mayo Clinic in Rochester, Minn., discusses the results of a study of 1,000 patients who have primary myelofibrosis.

Key findings
Researchers found that when patients with myelofibrosis present, their clinical features are not at a steady state and usually progress within the first few months of the diagnosis. It is best to wait a several months before providing a prognostic score.

Many patients with primary myelofibrosis can live a long life (exceeding 15 years) and patients who won’t live that long can be identified.

The most recent version of DIPSS-plus scoring system performed much better than prior versions, helping researchers to determine what proportion of patients with myelofibrosis are suitable for therapies. More than 50 percent of patients require observation alone.

A description of the study is included in the January 2012 issue of Mayo Clinic Proceedings.

ABSTRACT
Objective
To share our decades of experience with primary myelofibrosis and underscore the importance of outcomes research studies in designing clinical trials and interpreting their results.

Patients and methods
One thousand consecutive patients with primary myelofibrosis seen at Mayo Clinic between Nov. 4, 1977, and Sept. 1, 2011, were considered.

The International Prognostic Scoring System (IPSS), dynamic IPSS (DIPSS), and DIPSS-plus were applied for risk stratification. Separate analyses were included for patients seen at time of referral (N=1000), at initial diagnosis (N=340), and within or after 1 year of diagnosis (N=660).

Results

To date, 592 deaths and 68 leukemic transformations have been documented. Parameters at initial diagnosis vs time of referral included:

Median age (66 vs 65 years)
Male sex (61% vs 62%)
Red cell transfusion need (24% vs 38%)
Hemoglobin level less than 10 g/dL (38% vs 54%)
Platelet count less than 100 × 10⁹/L (18% vs 26%)
Leukocyte count more than 25 × 10⁹/L (13% vs 16%)
Marked splenomegaly (21% vs 31%)
Constitutional symptoms (29% vs 34%)
Abnormal karyotype (31% vs 41%)

Mutational frequencies were 61% for JAK2V617F, 8% for MPLW515, and 4% for IDH1/2.

DIPSS-plus risk distributions at time of referral were 10% low, 15% intermediate-1, 37% intermediate-2, and 37% high. The corresponding median survivals were 17.5, 7.8, 3.6, and 1.8 years vs 20.0, 14.3, 5.3, and 1.7 years for patients younger than 60 years of age.

Compared with both DIPSS and IPSS, DIPSS-plus showed better discrimination among risk groups. Five-year leukemic transformation rates were 6% and 21% in low- and high-risk patients, respectively.

Conclusion
The current document should serve as a valuable resource for patients and physicians and provides context for the design and interpretation of clinical trials.

AUTHORS
Ayalew Tefferi, M.D., Terra L. Lasho, M.T., Thitina Jimma, M.D., Christy M. Finke, B.S., Naseema Gangat, MBBS, Rakhee Vaidya, MBBS , Kebede Hussein Begna, M.D., Aref Al-Kali, M.D., Rhett P. Ketterling, M.D., Curtis A. Hanson, M.D., Animesh Pardanani, MBBS, Ph.D.

Source: http://physicianupdate.mayoclinic.org/2012/03/15/one-thousand-patients-with-primary-myelofibrosis-the-mayo-clinic-experience/

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Assess Your Risk: Should You Be Thinking About Glaucoma?

When it comes to protecting our eye health, we all know the most obvious signs and symptoms to watch out for – blurriness, halos and other changes in vision. With glaucoma, however, the condition often doesn’t present any symptoms in its early stages. Often referred to as a “silent thief of sight,” it’s for this reason that patients need to understand potential risk factors for the condition and schedule regular glaucoma screenings. A common and serious condition, we are challenging our patients to consider one important question: Should You Be Thinking About Glaucoma?

Here is our list of the Top 5 Risk Factors for Developing Glaucoma:

Age. Age is one of the most common risk factors for developing glaucoma. In fact, according to the Glaucoma Research Foundation, “You are six times more likely to get glaucoma if you are over 60 years old.”
Family History. Pointing to a genetic link, those with a family history of glaucoma tend to have a much higher chance for developing the condition. It’s important for patients to understand their family’s medical history and share it with their healthcare provider.
Certain Medical Conditions. Certain medical conditions have been marked as potential risk factors for glaucoma. In fact, according to the Mayo Clinic, “Several conditions may increase your risk of developing glaucoma, including diabetes, heart diseases, high blood pressure and hypothyroidism.”
Ethnicity. Some ethnic groups tend to be more vulnerable to developing glaucoma. Typically, these include African Americans and Hispanic populations.
Taking Certain Medications. Certain medications have been marked as potential contributing factors to glaucoma, particularly steroids. According to the GRF, “A 1997 study reported in the Journal of American Medical Association demonstrated a 40% increase in the incidence of ocular hypertension and open-angle glaucoma in adults who require approximately 14 to 35 puffs of steroid inhaler to control asthma.”

Schedule a Glaucoma Screening Today

Whether or not you are in one of these “high risk” categories, understand that glaucoma does not discriminate and everyone is ultimately at risk. This is why we are encouraging all our patients to contact us today and schedule a glaucoma screening. Our offices are located in Winchester, serving Virginia, West Virginia and Maryland, and you can reach us directly at (540) 722-6200.

Source: http://www.seeclear.com/blog/glaucoma/assess-your-risk-should-you-be-thinking-about-glaucoma

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Simplifying LASIK Basics – Part 1: Starting Points

As we’ve mentioned here before, LASIK has become a household word to anyone relying on glasses or contact lenses for everyday things. There’s no shortage of info out there, and much of it can be confusing, or written like an owner’s manual. At Eye Consultants of Texas, we cover the bases in educating our Dallas/Fort Worth LASIK patients, and try to do this as simply as possible. With that in mind, this is the first in a series of blogs we’ll be posting to highlight the basics of LASIK, in hopes of putting LASIK medical-speak more into simple-speak.

First Things First. LASIK is a simple, painless procedure that can be performed quicker and safer than ever before, mostly thanks to technological advancements. LASIK is also surgery on your eyes, so you owe it to yourself to understand the benefits, risks, and everything else about it. And to choose a skilled doctor who’s on your side.

How Long Has LASIK Been Around? A question to this that often follows is, “how many LASIK procedures have been performed?” To answer this objectively, we’ll go to a reputable source. According to the American Academy of Ophthalmology (AAO), LASIK was first FDA-approved in 1998. Since then, the AAO estimates that nearly 10 million procedures have been performed in the U.S. (an average of 700,000 each year). Worldwide, this number is double by some estimates you might find.

Why Would Someone Get LASIK? People who have LASIK performed are usually those that have to rely on glasses or contact lenses for everyday activities. Sometimes they opt for LASIK so they can see better and look better, or simply because they’re tired of having to wear glasses all the time. Sometimes LASIK may be the best solution if corrective eyewear is no longer doing the trick. Whatever the reason, it’s important that your vision health and overall health checks out, that you’re fully informed, and that you’re over 18 years of age. In other words, you have to be a candidate for LASIK to have it done. If for any reason you’re not, there are other options your doctor can tell you about.

Look for more in our next Simplifying LASIK Basics blog coming soon. Meanwhile, if you’d like to know more about LASIK at Eye Consultants of Texas, please call our office in Grapevine at 877-516-4364, conveniently located to Dallas/Fort Worth.

This blog is a general overview of LASIK surgery for general informational purposes only, and in no way intended as actual medical advice. Always seek a medical or eye care professional for advisement based on your individual health and eye care needs.

Source: http://www.eyectexas.com/blog/lasik-basics-part-1/

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Interview With Wendy Schauer – Author of The 7 Steps To Amazing Health!

Here is a link to an interview that “foodie”, health advocate, and grass fed beef rancher Lisa Wilcox recently did with author Wendy Schauer.

http://nwlocalgrassfedbeef.com/interview-with-wendy-schauer-author-speaker-chiropractor-kettlebell-trainer/

Yours In Health!

G.E. Moon II

Source: http://www.abundanthealthcenter.com/blog/interview-with-wendy-schauer-author-of-the-7-steps-to-amazing-health

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American Diabetes Month® | The Importance of Comprehensive Eye Exams

November marks the start of the American Diabetes Month®, an event sponsored by the American Diabetes Foundation®. A leading cause of blindness among adults, ExamHealth reports on something that every diabetes patient should be thinking about this time of year: a comprehensive eye exam.

“The American Optometric Association (AOA) is reminding Americans with diabetes about the importance of scheduling annual, dilated comprehensive eye exams to help detect and even prevent eye and vision disorders that could lead to blindness,” explains ExamHealth. “Each year, 12,000 to 24,000 individuals lose their sight because of diabetes.” An all-too-common condition in the US, the American Diabetes Foundation reports that nearly 26 million Americans are living with the condition.

What’s more, “The AOA notes that the results from its 2012 American Eye-Q® consumer survey revealed that only 44% of Americans are aware that diabetic eye disease often has no visual signs or symptoms,” reports ExamHealth. “Additionally, 43% of Americans are unaware that a person with diabetes should have a comprehensive eye exam once a year.”

Not sure what you should be looking out for? Read on!

Diabetes and Your Eye Health

So, why are comprehensive eye exams so important for those living with diabetes? The answer is simple – those with diabetes are at a significantly higher risk for developing several of today’s most serious eye conditions. Here’s a brief introduction:

Glaucoma: Glaucoma is an eye disorder characterized by an increased pressure in the eye. A leading cause of blindness in the US, glaucoma is a progressive condition that causes a gradual loss of vision. And, while there is no cure, glaucoma can often be treated with eye drops and certain other medications. In some cases, we treat the condition with lasers or surgery. A condition where early detection is everything, diabetes sufferers need to be even more vigilant when it comes to regular glaucoma screenings.
Cataracts: You can think of a cataract as a clouding of the eye’s lens. A progressive condition, cataracts can ultimately affect one’s ability to see clearly. Most common among older patients, those with diabetes are also at an elevated risk for developing the condition. When it comes to treatment, patients will often benefit from Cataract Surgery. During the procedure, the eye’s natural lens is removed and replaced with an artificial lens also known as an Intraocular Lens (IOL).
Diabetic Retinopathy: Diabetic retinopathy is a condition that weakens the blood vessels that supply nourishment to the retina. This is the light-sensitive lining in the back of the eye where vision is focused. As these vessels leak, swell or develop thin branches, vision loss can ultimately occur. Our practice offers comprehensive Diabetic Eye Care including routine eye exams.

Schedule Your Eye Exam Today

Make sure you schedule your comprehensive eye exam this November! Our offices are located in in Winchester, serving Virginia, West Virginia and Maryland, and you can reach us directly at (540) 722-6200. Contact us today.

Source: http://www.seeclear.com/blog/eye-heath/american-diabetes-month%c2%ae-the-importance-of-comprehensive-eye-exams

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Wednesday, February 27, 2013

Blocked fallopian tubes – successful Natural IVF

Claudia*, 35, already had a child after aggressive, conventional IVF, and wanted another. However, because she had blocked tubes, she needed IVF. She was exhausted after her conventional IVF and said “never again”! It had been very aggressive IVF, had cost her nearly £9000 and she had lots of unpleasant side effects. She had never [...]

Source: http://www.createhealthclinics.org/blog/natural-cycle-ivf/blocked-fallopian-tubes-successful-natural-ivf/

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Adventure Doc: Weekly on Expedition and Travel Medicine

Source: http://adventuredoc.net/2012/03/06/adventure-doc-weekly-on-expedition-and-travel-medicine/

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Welcome to Our Blog

Hello and welcome to the blog for Grochmal Eye Center! We’ve created this resource to assist our patients who are considering vision correction. Our goal is to provide you with information about the latest technology and procedures in vision care. Our blog will also serve as a forum for patients to learn about their surgical options from our Baltimore, Maryland Ophthalmologist, Dr. Jay C. Grochmal.

Source: http://www.grochmaleye.com/uncategorized/hello-world/

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A nurse practitioner-directed intervention improves the quality of life of patients with metastatic cancer

Gerardo Colon-Otero, M.D., with the Department of Hematology/Oncology at Mayo Clinic in Florida, discusses results of a randomized pilot study that show that an intervention that explains the benefits of hospice and addresses advanced directives early in the course of treatment leads to measurable improvement in the patient’s emotional and mental quality of life (QoL).

The study was published in the Journal of Palliative Medicine online ahead of print on May 4, 2012.

ABSTRACT
Background
There is a paucity of randomized studies evaluating the value of palliative interventions on a prospective basis in newly diagnosed oncology patients. We sought to prospectively evaluate quality of life (QoL) outcomes in advanced cancer patients who received discussion-based palliative care interventions from an advanced registered nurse practitioner (ARNP) integrated into the oncology team, and compare these outcomes with a control population.

Methods
Patients with metastatic cancer were randomized to standard care or an ARNP-directed intervention that included discussions of the benefits of hospice, discussions on living wills and advanced directives (Five Wishes document) along with an assessment of QoL. Relevant endpoints included change from baseline QoL and improvement in hospice knowledge.

Results
From Nov. 13, 2008, through July 28, 2009, 26 patients were accrued at the Mayo Clinic in Jacksonville, Fla. The study closed early due to published data demonstrating the benefits of early palliative care interventions in the management of metastatic cancer patients. Statistically significant improvements from baseline were noted in emotional and mental QoL assessments in the intervention group that were not seen in the control group. Patients found it useful to have the living will and Five Wishes documents offered as part of the ARNP intervention.

Conclusions
An ARNP-directed intervention that explains the benefits of hospice and addresses advanced directives early in the course of metastatic cancer patients’ treatment is well-received by the patients and their relatives and leads to measurable improvement in the patient’s emotional and mental QoL.

Authors
Gerardo Colon-Otero, M.D., Stephen H. Dyar, Jr., M.D., Mary M. Lesperance, A.R.N.P., Robert P. Shannon, M.D., Jeff A. Sloan, Ph.D.

Clinical trials at Mayo Clinic
Metastatic cancer, to bone

Source: http://physicianupdate.mayoclinic.org/2012/05/23/a-nurse-practitioner-directed-intervention-improves-the-quality-of-life-of-patients-with-metastatic-cancer/

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Reducing our Environmental Impact to Create Healthy Communities

Note: Today we have a guest blog post from Bernard Tyson, president and chief operating officer of Kaiser Foundation Hospitals, Inc., and Kaiser Foundation Health Plan. He recently wrote about Kaiser Permanente’s work to reduce its environmental footprint – not just as an business imperative, but as a core strategy for improving the health of its members and the communities it serves. Read more about Bernard Tyson through his bio in the Kaiser Permanente News Center.

There is little disagreement that greenhouse gas emissions, which are known contributors to climate change, have led to a rise in pollution and adverse health impacts. In fact, the World Health Organization estimates that urban air pollution causes about 1.2 million deaths per year and exacerbates cardiovascular and respiratory illnesses, particularly in sensitive populations like the elderly and young and in minority communities that are disproportionately impacted by urban and industrial activities.

Ironically, the health care industry – responsible for preventing and treating these types of illnesses – also contributes to the problem. According to a study by the University of Chicago, 8 percent of the total carbon emissions in the United States are attributable to health care activities. Not surprisingly, hospitals are by far the largest carbon emitters due in large part to strict requirements for temperature control, ventilation and lighting, and, of course, 24/7 operations.

Compounding the problem is the fact that many hospitals and health care facilities were built decades ago and have not been remodeled to use energy more efficiently. This is a similar situation to many government-owned buildings across the country. Late last year President Obama announced a multi-billion dollar government and private sector commitment to finance building renovations to make government-owned properties more energy efficient, and to create jobs in the process. The energy performance contracts proposed by the federal government, with improvements paid for by energy savings, are similar to those being used by schools, colleges and municipalities.

Given that the health care industry in America has nearly 600,000 facilities – and many of their workforces are equal in size to large government agencies (Kaiser Permanente’s workforce, for example, is of similar size as the U.S. Department of Homeland Security), health care organizations have a real opportunity to adopt sustainable business practices that reduce emissions, increase energy efficiency and the use of clean energy. This in turn will better protect public health and create jobs, achieving results that are in line with our focus on wellness and prevention, and helping grow the economy.

In January, Kaiser Permanente set an aggressive business strategy of reducing our greenhouse gas emissions by 30 percent by 2020, as compared to 2008 levels. To achieve this goal, we are adopting sustainable energy measures, both related to the construction of new facilities and the upgrading of existing facilities, such as installing new lights and window-film installations. These measures will not only reduce the impact of our operations on the environment, but are expected to save roughly $1 million per year in energy costs as well, which is good news for our members.

We are also investing in clean energy sources, such as deploying solar energy and fuel cell generation capacity at facilities throughout California. In Maryland and the District of Columbia, we are purchasing renewable energy credits to offset 100 percent of our carbon intensive activities in those markets.

And Kaiser Permanente is not alone. Last year for Earth Day, Digital Health committed to reducing greenhouse gas emissions and energy use, and increasing sourcing of power to green energy. The University of California at San Francisco has also established a robust sustainability strategy to reduce carbon emissions with an ultimate goal of becoming climate neutral.

I hope these climate change commitments are just the beginning for our industry. Together, we have an opportunity – and a responsibility – to help prevent climate related illnesses and improve the health of our communities.

Source: http://centerfortotalhealth.org/2012/tyson-healthy-communities/

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Deworming children in endemic zones

Source: http://adventuredoc.net/2012/07/26/deworming-children-in-endemic-zones/

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Tuesday, February 26, 2013

Economy class syndrome and blood clots in travelers

Source: http://adventuredoc.net/2012/02/17/economy-class-syndrome-and-blood-clots-in-travelers/

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Legionnaires’ disease in Quebec City – 40 sick and 3 deaths

An outbreak of Legionnaires’ disease in Quebec is the largest since 1995. The disease, known also as legion fever, is caused by bacteria that thrive in warm temperatures and can breed in the stagnant water of cooling towers, before being disseminated by the mist released from the system.

Legionnaires’ disease can also thrive in the supply systems of showers and Jacuzzis if the water supply is not kept at a sufficiently high temperature.

Travellers with respiratory symptoms who have used Jacuzzis or showers during their travels, or visited areas where there is known disease should consult their medical practitioners.

Source: ProMed Newsgroup

For further advice, contact the Globe Travel Health Centre on 01603 667323

Source: http://www.globetravelhealthcentre.com/travel-advice/legionnaires%e2%80%99-disease-in-quebec-city-%e2%80%93-40-sick-and-3-deaths.html?utm_source=rss&utm_medium=rss&utm_campaign=legionnaires%25e2%2580%2599-disease-in-quebec-city-%25e2%2580%2593-40-sick-and-3-deaths

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US Media: Unending Frustration (Part III) (Essay 24)

Source: http://bernardlown.wordpress.com/2011/08/22/us-media-unending-frustration-part-iii-essay-24/

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Shopping for LASIK? Want a chance to win the NEW iPad Mini?

Attend our How To Shop For LASIK event November 13, 6:30-7:30 PM.

It’s almost gift-giving season. If you have to depend on glasses or contacts every day, LASIK could be one of the best gifts you can give yourself. Whether you’ve been shopping for LASIK or not, our How To Shop event can help you shop smarter. In just 60 minutes, one of our expert doctors will give you the honest scoop in a simple way you can understand – what the procedure’s like, costs, financing, generally what to expect, and if you’re a candidate for LASIK.

But it gets even better.

Just for attending, you could win a cool new iPad Mini* we’ll give away that night! That’s right, this is a brand new iPad just announced, and sure to be the hottest ticket this holiday season. In fact, the new iPad Mini is so new, it may still be on order as of the date of this event. If you win, we’ll notify you immediately upon it’s arrival.

Remember that LASIK is an elective procedure, so it’s important to shop with your eyes open. Our How To Shop For LASIK event, November 13, is a good place to start. It’s Free, and we’re hosting it at our beautiful Grapevine offices. We’re located just off Hwy 114, convenient to Fort Worth and Dallas Metro.

To reserve your space, call us in Grapevine at 877-516-4364 today.

*Single winner will be determined by random drawing. There’s no purchase necessary, but you must be 18 years or older to attend, and be present to win.

Source: http://www.eyectexas.com/blog/shopping-for-lasik/

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Doctor as scientist, healer, magician, business entrepreneur, small shopkeeper, or assembly line worker — which is it? (Essay 30)

Source: http://bernardlown.wordpress.com/2012/06/26/doctor-as-scien/

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Vertebral Augmentation Video

Vertebral augmentation is a surgical procedure used to treat a compression fracture of the spine. This is an alternative to vertebroplasty or kyphoplasty and has the same goal as those procedures - to stabilize the collapsed vertebra and bring pain relief to the patient.

Short Teaser:

Vertebral augmentation is a surgical procedure for treating spinal fractures.

Thumbnail:

Source: http://www.spine-health.com/video/vertebral-augmentation-video

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Monday, February 25, 2013

Doctor as scientist, healer, magician, business entrepreneur, small shopkeeper, or assembly line worker — which is it? (Essay 30)

Source: http://bernardlown.wordpress.com/2012/06/26/doctor-as-scien/

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How to start a Walking Movement in the United States

With obesity among Americans at an all-time high, it’s more important than ever to encourage people of all ages to be active. On December 5, more than one hundred people convened at the Center for Total Health to formulate a plan to advance walking and activity in the United States. Participants came from a variety of organizations working on transportation, public health, science, medicine, and children’s issues.

Highlights of the day included two walking meetings (indoor and out) for all participants and remarks from the nation’s physician, U.S. Surgeon General Regina Benjamin, MD (seen in the photo above, talking with Kaiser Permanente’s Bob Sallis, MD), Scott Bricker, Executive Director of America Walks, and Tyler Norris, Vice President of Kaiser Permanente.

For more information on the benefits of walking, visit Every Body Walk!’s website or follow them on Twitter. More photos from the event can be seen here.

Source: http://centerfortotalhealth.org/2012/how-to-start-a-walking-movement-in-the-united-states/

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Is LASIK Right for Me?

As an ophthalmologist in Winchester, one of the top questions I’ll hear time and time again is, “Is LASIK right for me?” And, simply put, there’s no simple answer! Only a qualified medical professional can determine if LASIK’s right for you. There are, however, certain factors that good LASIK candidates share.

Not sure where to look? To get you started, here are a few questions to ask yourself:

Are you in good health? Good candidates for LASIK are healthy and free of autoimmune disorders such as Lupus, HIV and muscular sclerosis.
Do you have any eye conditions? Certain eye conditions are not compatible with laser eye surgery. Often, these include cataracts, chronic corneal infections or keratoconus.
Are you the right age? In the US, LASIK is FDA approved for patients over the age of 18. On the other hand, if you’re worried you’re too old for a LASIK procedure, consider this: Reporting on a recent study on LASIK in older patients, WebMD explains that, “Patients in their 60s were just as likely to have good [LASIK] outcomes as those in their 40s and 50s.”
Is your dependence on glasses or contacts holding you back? For many patients, reducing their dependence on glasses and contact lenses is a major reason they’re exploring LASIK in the first place. A lot of folks find glasses and contacts to be uncomfortable, inconvenient and unattractive. And, while it can’t guarantee that you’ll never need to put on a pair of glasses again, LASIK will very often reduce a patient’s dependence on them.
Are you ready to learn more? Finally, a good LASIK candidate is an informed LASIK candidate. Be sure to understand the potential risks and benefits of the procedure, maintain realistic expectations, and most importantly, schedule a consultation with a qualified LASIK surgeon.

Schedule a LASIK Consultation Today

To learn more about laser eye surgery, don’t hesitate to contact us today. Together, we can find the best treatment options for you. Our offices are located in Winchester, serving Virginia, West Virginia and Maryland. Book your appointment at (540) 722-6200.

Source: http://www.seeclear.com/blog/lasik/is-lasik-right-for-me

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The flu season has now started!!

Winter flu outbreak has now started – and it looks as though it may be a much worse season than last year.

Just as a couple of winters ago, children seem to be catching flu as well.

Globe Travel Health Centre has stocks of flu vaccine, and will also vaccinate the under 16s…

For further advice, contact the Globe Travel Health Centre on 01603 667323

Source: http://www.globetravelhealthcentre.com/travel-advice/the-flu-season-has-now-started.html?utm_source=rss&utm_medium=rss&utm_campaign=the-flu-season-has-now-started

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A Maverick’s Lonely Path in Cardiology (Essay 28)

Source: http://bernardlown.wordpress.com/2012/03/10/mavericks-lonely-path-in-cardiology/

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Glaucoma Worsens in Winter, Reports National Post

Sad as it is, Summer is almost at its end. Soon, we’ll be trading in our swimsuits and sandals for scarves and sweaters. And, while we typically associate the season with shorter days, changing leaves and cooler weather, researchers are now explaining that the cold months of winter may also have a profound impact on something far more important – your eye health.

“A study done at the Devers Eye Institute in Portland, Ore., found [Glaucoma] worsens in cold weather, especially among people in early stages of the disease,” reports Canada’s National Post. “The more extreme the weather patterns, the greater the impact on a person’s intraocular pressure and sensitivity.” Glaucoma, which is the leading cause of blindness and visual impairment in the US, is commonly associated with an increased pressure in the eye. The condition can affect patients of all ages, many of whom do not experience any symptoms and may not be aware that they have the disease.

And, while still a new study, these findings serve as an important reminder: although winter is still a few months out, take the time to come in for a glaucoma screening. If you think you may already be suffering from the condition, explore glaucoma treatment today!

Treatments for Glaucoma

Glaucoma is a progressive condition, and once it has been diagnosed, treatment should begin as soon as possible to help minimize the risk of permanent vision loss. While there is no cure for glaucoma, there are treatments available. These tend to focus on relieving symptoms and preventing further damage from occurring.

Common glaucoma treatments include:

Eye Drops: Glaucoma eye drops are typically used to reduce fluid production in the front of the eye or to help drain excess fluid.
Laser Surgery: Laser surgery for glaucoma works to increase the outflow of fluid from the eye or eliminate fluid blockages.
Microsurgery: Microsurgery works to reduce pressure in the eye by creating a new drainage channel, allowing fluid to drain from the eye.

Glaucoma Treatment in Winchester

To schedule an eye exam or to learn more about Glaucoma Treatment, contact us today. Our Ophthalmology Offices are located in Winchester, serving Virginia, West Virginia and Maryland. Book your appointment at (540) 722-6200. We look forward to hearing from you.

Source: http://www.seeclear.com/blog/glaucoma/glaucoma-worsens-in-winter-reports-national-post

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Sunday, February 24, 2013

West Nile Virus infection in many states of USA

The majority of states in the USA have reported cases of West Nile Fever (WNF) this year.

In those people who were severely infected, about half went on to develop meningitis or encephalitis. Most cases however, are mild and without symptoms.

This disease was first detected in the States in 1999, and this year’s numbers are the highest so far.

The greatest numbers of cases have occurred in six states (Texas, Mississippi, Luoisiana, Oklahoma, South Dakota and California), with Texas having almost half of those cases.

WNV virus is spread by Culex mosquitos, which bite mainly from dusk to dawn. Travellers should take measures to avoid mosquito bites, such as covering up after dusk and using effective repellents.

Source: ProMED-Mail

For further advice, contact the Globe Travel Health Centre on 01603 667323

Source: http://www.globetravelhealthcentre.com/travel-advice/west-nile-virus-infection-in-many-states-of-usa.html?utm_source=rss&utm_medium=rss&utm_campaign=west-nile-virus-infection-in-many-states-of-usa

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Simplifying LASIK Basics – Part 2: What’s Involved

Welcome to the second in our Simplifying LASIK Basics series. In this edition, we’ll highlight what the procedure’s like and types of LASIK in a way that should keep it simple. Hopefully it can help you determine what types of questions to ask your doctor as part of your decision to have LASIK performed.

What’s The Procedure Like? Although there’s more to it than this, here are the basics. Big Picture: Laser technology reshapes your cornea so things look sharper and clearer. Who It’s For: Mainly for anyone who is nearsighted, farsighted or has astigmatism. What Happens: A “flap” is created in the cornea, then the flap is gently lifted and folded back, and the cornea is reshaped using laser pulses to correct focusing problems in the eye. On average, it takes approximately 5 minutes, and may take slightly longer if your vision problems are more severe.

Types Of LASIK. Essentially, there are three basic types of LASIK, each designed to do what LASIK is supposed to do – help you see better, possibly better than you ever have with less dependency on glasses or contact lenses. You may have seen types of LASIK referred to this way: Conventional LASIK, Wavefront-Optimized LASIK, and Wavefront-Guided LASIK (also called Custom LASIK).

Which Type Of LASIK Is Best? Different doctors may use different types for different reasons. At Eye Consultants of Texas, we use a system based on Custom LASIK. It brings together two highly advanced technologies for a procedure branded “iLASIK.” Dr. Labor selected this after careful evaluation, mainly because it has proven to be more efficient and successful than other LASIK technologies he has used. But also, because of what it was designed to do – give the surgeon more control in customizing the procedure to each patient’s eye to get the best results. While the technology itself is extremely important, it’s even more important that your doctor has the skill and expertise to use it! Having been the first in the U.S., Texas, or locally to perform new procedures, Dr. Labor does his homework, and trains extensively on new technologies and advancements before ever putting them to use.

Until our next Simplifying LASIK Basics blog, if you’d like to know more about LASIK at Eye Consultants of Texas, please call our office in Grapevine at 877-516-4364. We’re conveniently located to Dallas/Fort Worth.

This blog is a broad overview of LASIK surgery for general informational purposes only. In no way is it intended as actual medical advice. Always seek a medical or eye care professional for advisement based on your individual health and specific eye care needs.

Source: http://www.eyectexas.com/blog/lasik-basics-2/

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Deworming children in endemic zones

Source: http://adventuredoc.net/2012/07/26/deworming-children-in-endemic-zones/

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Shopping for LASIK? Want a chance to win the NEW iPad Mini?

Attend our How To Shop For LASIK event November 13, 6:30-7:30 PM.

But it gets even better.

To reserve your space, call us in Grapevine at 877-516-4364 today.

*Single winner will be determined by random drawing. There’s no purchase necessary, but you must be 18 years or older to attend, and be present to win.

Source: http://www.eyectexas.com/blog/shopping-for-lasik/

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Careers As Advanced Health Care Practitioner In Demand

According to data collected by the American Medical Group Association’s and Cejka Search 2011 Physician Retention Survey, careers in the advanced health care field are growing rapidly. As such, employment in medical groups for nurse practitioners (“NPs”) and physician assistants (“PAs”) has increased significantly in the past five years. According to the data, 75% of the responses to the survey indicated more NPs and PAs will be hired in the next five years.

Growth in these advanced health care professions is due largely to economics, according to an article in U.S. News and World Report. NPs, for example, can provide patients with many primary health care services at a fraction of the cost of an internist. In addition, FiercePracticeManagement reports that due to physician shortages and the demand to create a medical “team” to care for patients (accountable care organizations, “ACO”), medical groups are employing the NP and PA at increasingly high rates. This gives NPs and PAs the advantage of choosing where to work, thus creating a high turnover rate for these positions. In addition, recruiting and retaining these professionals are challenges to medical groups.

Meiselman, Denlea, Packman, Carton & Eberz P.C. offers legal advice to physicians on medical issues. If you need legal assistance or guidance on a matter regarding your practice, please call our office.

Source: http://www.pagingdrblog.com/2012/04/17/careers-as-advanced-health-care-practitioner-in-demand/

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Saturday, February 23, 2013

A nurse practitioner-directed intervention improves the quality of life of patients with metastatic cancer

The study was published in the Journal of Palliative Medicine online ahead of print on May 4, 2012.

Authors
Gerardo Colon-Otero, M.D., Stephen H. Dyar, Jr., M.D., Mary M. Lesperance, A.R.N.P., Robert P. Shannon, M.D., Jeff A. Sloan, Ph.D.

Clinical trials at Mayo Clinic
Metastatic cancer, to bone

Source: http://physicianupdate.mayoclinic.org/2012/05/23/a-nurse-practitioner-directed-intervention-improves-the-quality-of-life-of-patients-with-metastatic-cancer/

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Understanding LASIK | Your Top 5 Questions Answered

At first glance, LASIK can seem like a confusing or complicated subject. As a result, many patients don’t explore their LASIK options, for fear of being misinformed or not understanding the procedure completely. Because we want all our patients to find out what laser vision correction can do for them, we thought we would take a moment to “de-mystify” LASIK and answer some of the most common questions we’re hearing. It’s time to set the record straight!

Here is our list of the Top 5 Patient Questions About LASIK:

What is LASIK in a nutshell? The goal of a LASIK procedure is simple: to improve vision and reduce a patient’s dependence on corrective lenses. The procedure uses special light energy to reshape the cornea, effectively combating the affects of nearsightedness, farsightedness and astigmatism.
Are all LASIK procedures the same? There are several types of LASIK procedures available today – each with their own unique benefits. Our practice is proud to offer what many are considering the gold standard in modern laser vision correction: iLASIK™. Using 3D eye mapping to create a fully-customized treatment plan, iLASIK is completely bladeless and relies on cutting-edge “cool laser” technology to safely reshape the cornea.
Is LASIK painful? While tolerance can sometimes vary, LASIK is generally regarded as a “relatively painless” procedure. Very often, the only sensation patients report is a slight pressure. Furthermore, we work to ensure patient comfort by administering numbing eye drops before the procedure.
Are most patients happy with their results? While each patient is different and can expect unique results, LASIK tends to be a highly successful procedure. In fact, “LASIK vision correction has the highest patient satisfaction rate of any elective surgery,” reports The Eye Surgery Education Council, “95.4%, according to a 10-year survey of scientific studies from around the world.”
How can I find out if LASIK is right for me? In general, LASIK patients tend to be in good health, free of eye conditions such as cataracts, over the age of 21. But, since there are other factors to consider in determining a good candidate for LASIK, we encourage anyone interested to schedule a consultation and find out what laser vision correction can do for them.

Considering LASIK? Learn More Today

To learn more about Laser Eye Surgery, contact us today. Together, we can find the best treatment options for you. Our offices are located in Winchester, serving Virginia, West Virginia and Maryland. Book your appointment at (540) 722-6200.

Source: http://www.seeclear.com/blog/uncategorized/understanding-lasik-your-top-5-questions-answered

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Venous Access in Austere Settings: Part One

Source: http://adventuredoc.net/2012/12/02/venous-access-in-austere-settings-part-one/

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The flu season has now started!!

Winter flu outbreak has now started – and it looks as though it may be a much worse season than last year.

Just as a couple of winters ago, children seem to be catching flu as well.

Globe Travel Health Centre has stocks of flu vaccine, and will also vaccinate the under 16s…

For further advice, contact the Globe Travel Health Centre on 01603 667323

Source: http://www.globetravelhealthcentre.com/travel-advice/the-flu-season-has-now-started.html?utm_source=rss&utm_medium=rss&utm_campaign=the-flu-season-has-now-started

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New York State Governor Investigates Out-Of-Network Costs

New York State Governor Andrew Cuomo recently announced the continuation of an investigation into out-of-network medical costs. In 2011, the state received more than 2,000 complaints from consumers who unexpectedly received bills from out-of-network specialists and providers after taking measures to choose in-network providers and receive prior insurer approval. Consumers often are not told in advance which specialists are out-of-network, how much they charge, and how much of their fee will be covered by health insurance. The resulting bills contribute to financial strain on consumers, many of whom are unable to pay the amount charged and some of whom are forced into bankruptcy.

To aid consumers in obtaining information on out-of-network care, costs, and coverage, the New York State Department of Financial Services is calling for more transparency, better consumer protection, and system-wide reform. This follows efforts by the Obama administration to require health insurers to provide such easy-to-understand information to consumers. If you are concerned about the potential impact of reforms and new rules, please feel free to contact us to discuss your options and assist you in making decisions regarding your practice.

Source: http://www.pagingdrblog.com/2012/03/15/new-york-state-governor-investigates-out-of-network-costs/

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Black Blood Must Not Contaminate White Folks (Essay 25)

Source: http://bernardlown.wordpress.com/2011/09/03/black-blood-must-not-contaminate-white-folks/

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Friday, February 22, 2013

Mayo Clinic offers newly approved treatment for GERD

C. Daniel Smith, M.D. , chair of the Department of Surgery at Mayo Clinic in Florida, discusses minimally invasive surgical options for patients with gastroesophageal reflux disease (GERD). A novel device, a ring of tiny magnetic titanium beads that acts to keep stomach acid from leaking into the esophagus, is now offered at Mayo Clinic in Florida. Read more about the LINX Reflux Management System in the April 11, 2012, edition of MedCity News.

Mayo Clinic in Florida is one of the first health care institutions in the U.S. to offer a newly approved device to treat GERD. Mayo Clinic in Florida helped test the device in patients. The U.S. Food and Drug Administration (FDA) approved the device and treatment procedure on March 22, 2012, for patients with GERD who continue to have chronic reflux symptoms despite taking medication. Mayo Clinic in Florida was one of 14 centers nationally that participated in a clinical trial that led to the FDA’s approval of the device.

About GERD
In patients with gastroesophageal reflux disease, liquid or food in the stomach flow back up into the esophagus due to the inability of a ring of muscle between the lower esophagus and the top of the stomach to close properly. If drugs aimed at neutralizing the acid in the stomach fails to prevent GERD, an operation designed to correct the mechanical defect is considered. Nearly 2 million patients of those patients could benefit from this treatment, which is much less complex than current surgical options, says Dr. Smith.

The results of the clinical study that led to approval of the device have not yet been published. “The data presented to the FDA, however, revealed striking results when compared to other GERD treatments that have been investigated over the past 20 years,” says Dr. Smith. “The system offers effective control of GERD with limited side effects and thus far an excellent safety record.”

The implanted device is a ring of tiny magnetic titanium beads that is wrapped around the junction between the stomach and esophagus, serving as a mechanical augmentation of the lower esophageal sphincter (the ring of muscle). The magnetic attraction between the beads is strong enough to keep the sphincter closed to refluxing acid, but weak enough so that food can pass through it into the stomach. The device can be implanted using minimally invasive surgery methods.

“I expect this device to be a game changer for the treatment of GERD in select patients who have failed management with drugs,” says Dr. Smith.

Kenneth R. DeVault, M.D. , chair of the Department of Internal Medicine at Mayo Clinic in Florida, also participated in the studies. “I have many patients who are searching for something more than medication for their reflux, but have been hesitant to undergo a traditional reflux surgery,” he says. “I think this procedure may well be a very attractive option for that group.”

Drs. Smith and DeVault were consultants to the company that developed the device and participated in the research study. Mayo Clinic licensed related technology to the company in exchange for equity.

For more information
View the Torax Medical, Inc. presentation at the January 2012 Gastroenterology and Urology Medical Devices Panel Meeting and read the FDA Executive Summary Memorandum.

Clinical trials at Mayo Clinic
Gastroesophageal reflux disease (GERD)

Source: http://physicianupdate.mayoclinic.org/2012/04/17/mayo-clinic-offers-newly-approved-treatment-for-acid-reflux-disease/

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Clinical trials aid PSC diagnosis and treatment

Jayant A. Talwalkar, M.D., a hepatologist with the Department of Gastroenterology and Hepatology and the Mayo Clinic Transplant Center in Rochester, Minn., discusses diagnosis, complications, liver transplantation, and Mayo’s role in the development of new diagnostic tests and effective therapies for patients with primary sclerosing cholangitis (PSC).

Dr. Talwalkar notes that PSC is the last major liver disease without effective treatment. There is currently no effective medical therapy to halt disease progression and so avoid complications such as liver failure or bile duct cancer for patients with PSC. PCS is considered an autoimmune condition. It develops silently, most often in patients 40-50 years.

Dr. Talwalkar’s team focuses on clinical trials for the development of diagnostic tests and effective drug therapies for PSC, before transplant is needed. Mayo specialists see several hundred patients with PSC each year.

Clinical trials at Mayo Clinic
Primary sclerosing cholangitis (PSC)

Research profiles
Jayant A. Talwalkar, M.D.

Source: http://physicianupdate.mayoclinic.org/2012/05/02/clinical-trials-aid-psc-diagnosis-and-treatment/

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Rock Health: Accelerating Innovation in Health Care

Innovation starts with a seed, an idea fueled by passion and a desire to make meaningful change by building on that which has come before and making it better. In no field is this perhaps more vital than in health care.

Rock Health, a seed accelerator and nonprofit foundation focused on the intersection of health care and technology, develops global strategies to enhance care delivery, patient-clinician relations, and the health and well being of people the world over. The organization is partnering with organizations, entrepreneurs, researchers, thought leaders and innovators across multiple fields, including medicine, technology, venture capital, and corporate industry to advance digital technology in health care – two fields that touch each of our lives. Through start-up funding, research and public events, the foundation supports next generation health entrepreneurs committed to supporting digital innovation in health care.

Kaiser Permanente recently announced its partnership with Rock Health as a sponsor to provide financial support and work closely with the seed accelerator’s network of change makers to explore new ways to leverage digital innovation to improve the health of communities across the globe. In this move, Kaiser Permanente joins several other health and business leaders—including the Mayo Clinic, Harvard Medical School, General Electric, Nike, Genentech and others—who support Rock Health and the important work it is doing.

For more information on Rock Health, including its incubator program, its events, its own blog, and more, check out the website here.

Source: http://centerfortotalhealth.org/2012/rock-health-accelerating-innovation-in-health-care/

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