StemCell Therapy

Nearly 400 livestock farmers from around Wales have joined a scheme designed to help them improve their animals health and boost their production.

The 395 beef and sheep farmers have signed up to a pro-active animal health planning project called Stoc+, which is promoted by Hybu Cig Cymru Meat Promotion Wales (HCC).

Stoc+ forms one part of HCCs three-strand, Welsh Government and European Union-funded Red Meat Development Programme (RMDP).

During the course of the five-year project, HCC will bring together up to 500 commercial sheep and beef producers across Wales and encourage them to adopt a prevention is better than cure approach to animal health.

Each participating farmer will receive practical, expert advice and specialist support for up to three years. In addition, all farmers will benefit from a tailor-made Flock and Herd Health Plan and Action Plan to work towards various targets set by their local veterinary practitioner.

As part of the project, the team have identified a small number of ambassadors who include farmers and veterinary practitioners. The ambassadors role includes encouraging their peers to get involved and demonstrating the practical benefits of proactive health planning in terms of animal health and farm profitability.

Jonathan Lewis from Llandrindod Wells is one of the ambassadors. Mr Lewiss upland farm has 80 Simmental, Limousin and Stabiliser cows and 1,680 Lleyn, Mules and Welsh Mountain sheep and lambs.

He said:

There were many reasons behind joining the project. I wanted to improve the overall health of my flock as well as increase the number of lambs that I sold whilst reducing the number of days to slaughter. During the course of the project, I would also like to reduce the antibiotics used on the farm and be advised on how to improve biosecurity.

Claire Jones of Dolgellau Vets is a vet ambassador for the project, and as a vet and farmers wife has a passion for preventative medicine and herd and flock health work.

Claire said:

Health planning is something that I feel should be an integral part of all farm management, as it improves the efficiency of the farm and health of the animals and also helps to improve the vet and farmer communication and relationship.

Stoc+ is supported by the Welsh Government Rural Communities Rural Development Programme 2014 2020, which is funded by the European Agricultural Fund for Rural Development and the Welsh Government.

For more information on the project and to meet other project ambassadors visit the HCC website.https://meatpromotion.wales/en/industry-projects/red-meat-development-programme

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Farmers Join Scheme to Boost Their Animals' Health - Business News Wales

By GILLIAN SLADE on February 15, 2020.

gslade@medicinehatnews.com

The Alberta Association of Optometrists says Alberta Health is asking for a 22 per cent reduction in fees for eye care for seniors and children.

In late December, the AAO received this communication from the government, said president Dr. Troy Brady.

We do feel that their proposals will result in poor eye health care for Albertans and greater overall cost to the system, said Brady, noting that a lack of preventative eye care will mean more people seeking attention in emergency rooms or needing a referral to a specialist. This would result in higher overall health-care expenses.

Alberta Health would not provide an interview to the News but submitted an emailed statement in response to questions.

Alberta has the highest per-capita spending in Canada, almost twice as high as Ontario, B.C. or Nova Scotia. This isnt sustainable, said Steve Buick, spokesperson for Alberta Health.

Brady says a comparison of fees with other provinces is not as simple as that.

In comparing rates Alberta Health has used some of the oldest and lowest fees to inform their request, said Brady. They found rates from other provinces that have not been updated for 15 years.

Brady says in some cases there are increases that are not reflected yet but will likely show up later in the year.

The AAO has had only two increases in fees in the past six years, and each of those was for one per cent, said Brady.

It does not begin to cover cost-of-living increases or inflation.

Alberta Health pays optometrists $56.32 for one complete eye exam every year for a child up to age 18. The fee for a senior, who also qualifies for one complete eye exam annually, is $80.70.

Alberta Health is suggesting the seniors exam should be reduced to $56.32, the same rate paid for a child.

The Alberta Association of Optometrists says there are complexities to an eye exam for a senior that do not exist with a child. Brady says seniors have more complicated eye conditions including other health conditions that can affect eye health.

They take more time. It takes longer to explain whats happening with their eyes and they often have multiple problems that we need to discuss, said Brady.

Alberta Health requested a reduction in optometrist fees and services totalling about $22 million, which equates to a 22.8 per cent cut to the estimated $96.5 million budget.

Brady says the AAO has submitted a counter proposal to Alberta Health that it believes will fairly compensate optometrists plus continue to ensure high quality and timely eye health care.

Depending on the outcome, there is the potential for patients affected to have to pay an additional fee for services.

They will then have to choose between paying this extra cost or asking to be referred to a specialist, a higher paid provider, said Brady.

Other changes suggested by Alberta Health include reducing the fee for computer-assisted visual fields and to delist completely retinal photography and retinal imaging.

The AAO had counter-proposed a 3.2 per cent reduction to fees over two years, which would allow Alberta Health to save about $8 million over the next three years.

Buick points out that no final decisions have been made by the government yet.

The AAO says many common eye diseases have no early signs or symptoms, which is why regular eye exams are recommended. Three quarters of vision loss and blindness can be prevented with early intervention.

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Osteoporosis drug investigated in premenopausal women to see if it reduces breast density

Washington University School of Medicine in St. Louis is conducting a phase 2 clinical trial to investigate an osteoporosis drug for its potential to lower breast density in women with dense breasts. Such women have a higher risk of developing breast cancer than women with lower breast density. Premenopausal, cancer-free women who have dense breasts and are planning to have a mammography at Siteman Cancer Center may be eligible to participate in this prevention trial.

Some 330,000 American women are diagnosed with breast cancer each year, and researchers at Washington University School of Medicine in St. Louis are seeking ways to reduce that number.

A new $3 million grant from the National Cancer Institute (NCI) of the National Institutes of Health (NIH) is supporting a phase 2 clinical trial to investigate an osteoporosis drug for its potential to lower breast density in women with dense breasts. Women with dense breasts have four- to six-times higher risk of developing breast cancer than women with lower breast density. The average woman has a one in eight chance of developing breast cancer over an 80-year life span.

The trial will investigate whether the drug denosumab, approved by the Food and Drug Administration (FDA) in 2010 to treat osteoporosis, can reduce breast density in premenopausal women with dense breasts and, in the future, could be used for breast cancer prevention in these women.

For women who have not yet gone through menopause, we do not have good preventative measures against breast cancer, said principal investigator Adetunji T. Toriola, MD, PhD, an associate professor of surgery in the Division of Public Health Sciences. About 25% of breast cancers are diagnosed in premenopausal women, but we have only one preventive therapy that has been approved for this group tamoxifen, a chemotherapy drug that has undesirable side effects, including early menopause. While severe side effects are rare, tamoxifen increases a womans risk of developing endometrial cancer, blood clots and stroke.

With such risks in mind, many women choose not to take tamoxifen to reduce their risk of breast cancer. Therefore, Toriola and his colleagues are seeking new preventive therapies that can reduce the risk of breast cancer with fewer undesirable side effects.

Women undergoing annual screening mammography at Siteman Cancer Center who are cancer-free and found to have dense breasts will be eligible to participate in this prevention trial. The researchers are seeking 210 participants. Trial participants must be at least 40 years old and premenopausal, and may meet any other criteria that suggest an increased risk of breast cancer, such as having a family history of the disease in a parent or sibling.

We go through these factors in detail with the possible study participants during the screening process, Toriola said.

The trial will not include women whose family histories of breast cancer are due to inherited mutations in the BRCA genes. Women with this genetic background and family history are at much higher risk of breast cancer, and their prevention options are different and more aggressive.

Breast density can only be assessed by having a mammogram. Dense breasts have more fibrous tissue and less fatty tissue. This trial is focused on women whose breasts show mostly fibrous or entirely fibrous tissue on a screening mammogram. About half of premenopausal women over age 40 have dense breasts. Breast density tends to decrease with age, with about 20% to 30% of women over age 70 having dense breasts.

Women with dense breasts who decide to participate in the trial will randomly be assigned to receive either the osteoporosis drug denosumab or a placebo. Denosumab is marketed under the brand names Xgeva and Prolia and has been shown to stop bone loss, thereby increasing bone density and reducing fractures associated with osteoporosis.

Denosumab blocks a molecular signaling pathway called RANK that, in addition to regulating bone remodeling, has been shown to play a role in the development of fibrous mammary gland structures as well as breast cancer in experimental models.

The safety and effectiveness of this drug is well established in its use as an FDA-approved therapy to prevent osteoporosis and bone fractures in older women, Toriola said. It is given as an injection under the skin in the upper arm, upper thigh or stomach area, but it only needs to be administered every six months, rather than daily like tamoxifen. So we hope that denosumab will provide an additional prevention option for women with dense breasts who are at high risk of developing breast cancer.

The participants will receive one dose of denosumab or placebo by injection at the first trial visit. Then participants will receive a second, and final, dose of either denosumab or placebo at the six-month mark. For all participants, the researchers will measure breast density by mammography at baseline and again after 12 months.

Denosumab does have side effects, including low calcium levels and muscle pain. The most severe side effect degeneration of the jaw bone is rare and resolves on its own when the drug is stopped, according to Toriola.

We would like to find out if, over time, the drug has an effect on breast density and molecular markers in the breast that we know are associated with breast cancer risk, Toriola said. We also would like to follow these participants yearly for the following three years to see if any effects on breast density continue over a longer period of time.

This initial phase is a five-year study, Toriola added. But we plan to pursue future renewals of funding in order to follow participants long enough to be able to measure whether the drug has any effect on breast cancer rates.

This work is supported by the NCI of the NIH, grant number R37CA235602.

Washington University School of Medicines 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

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Breast cancer prevention trial underway - Washington University School of Medicine in St. Louis

Over the last two decades, since its founding at the turn of the millennium, the Gates Foundation has given away $53.8 billion. In this years annual letter about the foundations activities, Bill and Melinda Gates take a look at whats worked (vaccines) and what hasnt (education) over the lifetime of the organizationand look forward to how they plan to give away the next billions.

At its best, philanthropy takes risks that government cant and corporations wont, they write. Governments, they argue, should focus on scaling up solutions that are already proven to work, and businesses have to think about profit, but foundations can experiment with different approaches.

For the Gates Foundation, which has focused its efforts to date on global health and on education in the U.S., one of the first experiments involved vaccines. They realized that children in some countries were dying from diseases that were easily preventable. Through a new alliance that it created called Gavi, the foundation worked with governments and other organizations to raise funds to buy vaccines.

They didnt know if it would workor whether governments in low-income countries would succeed in getting the vaccines to children. But it was a success. By 2019, the program had helped prevent 13 million deaths and vaccinated more than three-quarters of a billion children. It helped bring down the cost of one key vaccine by more than 70%. Still, a segment of hard-to-reach children still isnt getting vaccinated; the foundation now plans to work on getting basic vaccinations to all children.

Some of the foundations other work has been more challenging. The foundation made early bets on preventative medicine for HIV that had to be taken every day; while an effective daily preventive pill now exists, the team realized that it wasnt something that people realistically want to use in many locations, and it hasnt made a significant difference in preventing HIV in lower-income countries. In other cases, patients with HIV havent gotten treatment even when it was readily available because of the stigma. The foundation is now taking a broader look at what would help prevent the disease, including factors such as financial literacy and ending gender-based violence.

The foundations investments in education in the U.S. also havent gone as expected. If youd asked us twenty years ago, we would have guessed that global health would be our foundations riskiest work and our U.S. education work would be our surest bet, Melinda Gates writes. In fact, it has turned out just the opposite. One Gates-funded effort spent hundreds of millions trying to improve high school graduation rates in a handful of states by continually assessing teachers and offering assistance, but it didnt really help; most of the teachers were already rated as effective, and it wasnt clear how to help teachers improve.

Overall, the letter reports, more students are now graduating from high school, but many still dont go on to finish college. Part of the problem, Melinda Gates says, is that it still isnt clear which interventions work best, and solutions are also hard to scale upits better to tailor specific solutions to specific areas. The foundation is now focusing more effort on helping local networks of schools identify local solutions.

The foundation has sometimes been criticized for its choices; one editorial in the medical journal The Lancet, for example, argues that the Gates Foundation has focused on diseases such as malaria even in areas where other diseases cause more harm, diverting attention and resources away from necessary research. The foundation spends more on health than most countries and more than the World Health Organization but has less accountability.

Still, its clearly had an impact in the areas it does support, and its committed to continual improvement. We now have a much deeper understanding of how important it is to ensure that innovation is distributed equitably, they write in the letter. If only some people in some places are benefitting from new advances, then others are falling even further behind.

In the coming years, the foundation will also focus on two other key issues: climate changeincluding helping people in poorer countries adapt to the impacts caused by a changing climateand gender equality. Melinda Gates writes that progress on gender equality has been slow because the world has refused to make gender equality a priority. Thats something that the sheer scale of the Gates Foundation could help change. And it plans to continue making what it calls big bets in all of its work, taking risks on solutions that may not be successful but will have an outsized impact if they are. The goal isnt just incremental progress, the letter says. Its to put the full force of our efforts and resources behind the big bets that, if successful, will save and improve lives.

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Bill and Melinda Gates's annual letter looks back on 20 years - Fast Company

When it comes to affordable health care, most of the candidates miss the point.

If you make cholesterol medication affordable for all, there will be fewer admissions to emergency rooms for heart attacks.

If you make blood pressure medication affordable for all, there will be fewer admissions to emergency rooms for stroke.

If you make diabetic medication affordable for all, there will be fewer admissions to emergency rooms for congestive heart failure and emergency amputations.

Add to this the cost of ongoing care once, or if, the patients survive the condition. Ask any hospital CFO the cost of uninsured patients in the emergency room. These written-off costs get passed on to the rest of the medical clients.

According to Medicare and Medicaid (a rapidly diminishing source for the uninsured), most procedures wont be paid for unless done by a doctor. Many of these same procedures can be accomplished by a registered nurse or physicians assistant under a doctors orders. The key to financially sustainable health care does not lie in cutting services; it lies in providing better preventative medicine.

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Key to affordable care is better prevention | Letters To Editor - Greensboro News & Record

NDA Partners Chairman Carl Peck, MD, announced today that Dr. Linda McKibben, a former Pediatric Medical Officer/Clinical Reviewer in the Division of Vaccines and Related Products at the FDA Center for Biologics Evaluation and Research, has joined the firm as an Expert Consultant.

ROCHELLE, Va., Jan. 29, 2020 /PRNewswire-PRWeb/ --NDA Partners Chairman Carl Peck, MD, announced today that Dr. Linda McKibben, a former Pediatric Medical Officer/Clinical Reviewer in the Division of Vaccines and Related Products at the FDA Center for Biologics Evaluation and Research (CBER), has joined the firm as an Expert Consultant. Dr. McKibben's expertise includes pediatric therapies, pediatric trials, preventative medicine, public health, health policy, and clinical regulatory strategy.

Prior to joining the FDA, Dr. McKibben served in multiple roles at the US Centers for Disease Control and Prevention as Senior Advisor for Health Services Research at the National Center for Infectious Diseases (NCID), Senior Medical Officer in the Office of HealthCare Partnerships (OHP), and Medical Epidemiologist at the National Center for Prevention of Injuries (NCIPC). She has also served as a Senior Policy Analyst/Medical Director of Altarum Institute (Alexandria, Virginia), and Vice President of Health Policy at The Lewin Group (Falls Church, Virginia).

Most recently, she served as a Clinical Trials Medical Consultant for Ripple Effect Communications, where she supported the Deputy Director of Extramural Research at NIH's National Institute for Child Health and Human Development, and as a Medical Consultant in the Integrated Product Development Division of PAREXEL Consulting.

According to Dr. Carl Peck, "Dr. McKibben's first-hand knowledge and experience in pediatric therapies, pediatric trials, preventative medicine, and clinical regulatory strategy, both at the FDA and in the Industry, make her an excellent addition to our team of Expert Consultants. We are very pleased to welcome her to NDA Partners."

Dr. McKibben earned her medical degree from the Medical College of Georgia, Doctor of Public Health degree in Health Policy from the University of Michigan, Master of Public Health degree from Harvard University, School of Public Health, and bachelor's degree in microbiology/pre-medicine from the University of Georgia. She is a fellow of the American Academy of Pediatrics and board certified in preventative medicine.

About NDA Partners NDA Partners is a life sciences management consulting and contract development organization (CDO) focused on providing product development and regulatory services to the pharmaceutical, biotechnology, and medical device industries worldwide. The highly experienced Principals and Expert Consultants in NDA Partners include three former FDA Center Directors; the former Chief Executive Officer and Chief Science Officer at the United States Pharmacopeial Convention (USP); an international team of more than 100 former pharmaceutical industry and regulatory agency senior executives; and an extensive roster of highly proficient experts in specialized areas including nonclinical development, toxicology, pharmacokinetics, CMC, medical device design control and quality systems, clinical development, regulatory submissions, and development program management. Services include product development and regulatory strategy, expert consulting, high-impact project teams, and contract management of client product development programs.

Contact Earle Martin, Chief Executive Officer Office: 540-738-2550 MartinEarle@ndapartners.com

SOURCE NDA Partners LLC

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Dr. Linda McKibben, Former FDA Pediatric Medical Officer, Division of Vaccines and Related Products, Joins NDA Partners - Yahoo Finance

Primary care doctors do a lot of different things. We diagnose illnesses from the trivial, to the catastrophic. We treat maladies both chronic and acute. We confront, and we console.

Of course, these are common roles in medicine, filled by many different providers. One role the primary care physician is more uniquely suited to fill, however, and one of my personal favorites, is that of guide. Im talking specifically about the art of prevention, of maintaining wellness over the long term, and reducing the risk of diseases that might make it harder to do what you need to do, what you want to do, what you love to do.

Prevention is truly underutilized. We are a lot better at looking for a problem, and a pill or a procedure to fix it, than we are at fixing what might lead to a problem in the first place. In fairness, human beings are inclined to wait for the crisis to hit before we believe it is really and truly ahead. Changing habits is hard and eating takeout pizza while watching must-see TV is a lot less work than hitting the gym and making a salad.

On the other hand, some parts of prevention are easy. Its easy to get a flu shot, or a shingles shot. Its easy to get a mammogram, or a colonoscopy. Its easy to get blood drawn, and get checked for diabetes or hepatitis C.

Of course, its only easy to do these things if you are aware of the benefits of doing so. This is the value of the annual checkup. From birth, to your last birthday, wellness visits have an important role.

For infants and children, we monitor growth and development. For adults, we screen for diseases, and give advice on reducing risk factors that might lead to disease. Even the oldest of our old can benefit from simple tests for things such as hearing and memory. At every age, we think about safety: is that infant sleeping on her back? Is that teen wearing his seatbelt? Is that adult drinking and driving? Is that elderly person at risk for falls? Has that patient received their flu shot?

Under the Affordable Care Act, most insurance programs cover prevention visits with no copay. This even includes Medicare. Everyone can benefit from these opportunities to focus on staying well, rather than treating problems.

Prevention is an important part of being a primary care doctor, and an important reason to HAVE a primary care doctor. So, take your preventative action today, make a call and set up an appointment, just for that checkup.

Deb Johnston, M.D. is a contributing Prairie Doc author who has practiced family medicine for more than 20 years.

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Prairie Doc Perspectives - Your guide for prevention and wellness - The Capital Journal

NANJING, ChinaChinas rulers are now calling the coronavirus epidemic a major test of Chinas system and capacity for governance and Communist Party leader Xi Jinping is warning against any lack of boldness fighting it. But infections are rampant, the death toll is still mounting, and the country is increasingly isolated by a world community afraid this could become a pandemic. With no vaccine, hospitals overcrowded, and a dearth of solid information about how to treat the flu-like disease, what are Chinas 1.4 billion people (or the rest of us) supposed to do?

The answers have come on the internet: stay away from your pet dog, gargle salt water, fumigate with vinegar, take a potion made from flowers, and smoke a lot.

Yes, fake news has gone viral in the fight against the virus, which youd expect. But the picture is complicated by the Chinese medias advocacy of traditional Chinese medicine, and some half-baked reporting that credits U.S. President Donald Trump with possession of a "super drug" hell be willing to share real soon.

Chinese citizens hungry for any kind of protection against the disease have been posting and re-posting dubious reports about miracle cures and alternative medicine on the main Chinese social networks: the microblog Weibo and the chat app Weixin.

In a country where many hundreds of millions of people are currently holed up inside, on break from work, and thirsty for any new information about the deadly virus, such bad reporting and fake news that goes viral can provoke some frenzied side effects.

After Peoples Daily published an article claiming that scientists researching the novel coronavirus found shuanghuanglian oil, a traditional Chinese medicine concocted from three flowers, was effective treating it, believers in the efficacy of traditional medicine, or TCM, flocked to drug stores and bought up all of it they could find.

Sales and hype were such that the stock price of one producer, Fushen Pharmaceutical Co., soared by 120 percent on the Hong Kong stock exchanges as markets opened February 3. For a brief few minutes, founder and chairman and majority stakeholder Cao Changcheng was a billionaire, richer on paper than Huawei CEO Ren Zhengfei, until the speculative rush died down and the price fell back to its opening level. Even so, at 8 Hong Kong dollars a share it's worth twice what it was two weeks ago.

Combining multiple bullshit ideas, one Chinese blogger wrote, Its a disease carried by canines and spread to nearby dogs, dog-to-dog, then dog-to-human.

And while shuanghuanglian, which includes Japanese honeysuckle, Chinese skullcap, and forsythia suspensa and comes in tablet form as well as oil, might not be as dangerous to its users as drinking bleach (a cure recommended by QAnon conspiracy theorists in the United States) or consuming the dung and urine of cows, recommended by a swami in India, the injectable form can cause anaphylactic shock if administered to pregnant women or young children.

Although many Chinese publications claim that shuanghuanglian has been shown to be effective against influenza, respiratory illnesses, and a variety of ailments, they did have to report that there is no evidence to suggest it does anything against coronavirus.

Young Chinese laugh at the drama over shuanghuanglian. The Chinese characters used look and sound similar to the characters for double egg yolk lotus seed paste moon cake (shuanghuang lianrong yuebing), prompting the joke that after shuanghuanglian is sold out, people should buy moon cake. Consumption of all manner of TCM products is largely concentrated among their elders. When it is used, it is mostly as a preventative measure in addition to, not instead of, modern medicine. But various herbal products are hardly the only less-than-scientific solutions being offered.

Many viral messages advise people to swish diluted salt water around in their mouth before and after leaving the house as a means to kill the virus. This advice sometimes is attributed falsely to Dr. Zhong Nanshan, who discovered SARS in 2003. While salt water mouthwashes are sometimes used as a home remedy for sore throats or colds, they would do nothing against coronavirus, as multiple Chinese websites have noted.

Other false rumors about the virus claim it is spread by dogs, or that hanging clothes outside can disinfect them.

Combining multiple bullshit ideas, one Chinese blogger wrote, Its a disease carried by canines and spread to nearby dogs, dog-to-dog, then dog-to-human. Dogs do not get sick, but humans get sick. After humans get sick, they spread it to dogs, and the cycle continues. So, people must stay away from dogs. Families who raise dogs must keep their dogs inside the house, and you cannot play with your dog. Before going out, spray alcohol on your head and clothes. When you return home, wipe your hands, cell phone, and belongings with alcohol. Hang your coat on the open-air balcony to air it out, and gargle diluted salt water.

Young Chinese laugh at the drama over shuanghuanglian.

Some of the methods of prevention have to be jokes. One post claimed that smoking prevents all varieties of coronavirus because the oil from smoke coats ones lungs at a nanometer level, preventing coronavirus from striking the lungs cells, almost like your lungs are wearing a nanometer mask at the cellular level.

One piece of outright fake news was debunked by official national-level tabloid Global Times Monday afternoon. The false news, shared by a large number of Weibo users on February 2, asserted that there was an American super drug that could cure diseases caused by coronavirus and that President Donald Trump was going to fast-track its proliferation to China.

But the story is a little more complicated than smoking and puppy hoaxes.

Real highly effective drug has come out. It has gone through Americas process for effective medicines. Trump called on Americas Centers for Disease Prevention and Control to publicly release the formulation. I hope our researchers dont continue to be obsessed with huoxiang zhengqi/hyssop oral oil for vital energy [another Chinese medicine] and shuanghuanglian, and instead quickly try this medicine, one variation said.

The storyline shares much in common with pro-Trump posts swimming around right-wing corners of the American blogosphere. Theres a simple answer being hidden from the public, and perhaps an exaggeration of somevacuousstatement Trumputteredwithout thinking, aboutwhich conspiracy theorists will fill in the blanks.

What Trump did say in an interview with CNBC on January 22 was that, We have it totally under control. Its one person coming in from China, and we have it under control. Its going to be fine. We do have a plan, and we think its going to be handled very well.

Trump never said anything about America having any kind of secret or fast-track drug. The drug in question, remdesivir, has not been proven effective yet. It was previously tested as a treatment for Ebola in the Congo and performed worse than competitors, but its manufacturers say it has been useful against SARS and MERS, which also are coronaviruses.

The origin of the Chinese fake news apparently can be traced back to a post on January 29 by the Chinese website Science Net. That piece summarized Jon Cohens article in Science, published on January 27, about potential existing drug combinations that might work against coronavirus, before adding its own exaggerations and rhetorical flourishesthe super drug moniker.

In reality, Cohens article notes the apparent effectiveness of remdesivir in a study of mice, and cites a microbiologist agreeing that it is the most promising drug, while emphasizing that it is unproven and not available in China.

Gilead, the California-based maker of remdesivir, has issued a statement that the company is in active discussions with researchers and clinicians in the United States and China regarding the ongoing Wuhan coronavirus outbreak and the potential use of remdesivir as an investigational treatment. Whether or not remdesivir ultimately is made available, and whether it proves effective, does not hinge on Trump or the CDC, but on the New York Stock Exchange on Monday, Gilead shares shot up 5 percent.

Cohen, who has three decades of experience as a writer for Science and whose writing on coronavirus has been increasingly cited on Weibo, said by email, I hear from people all over the world, every day, including people from China. Many have questions I cannot answer. Some are pushing their own theories. Some want me to play doctor and want medical advice, which I cannot give. Some are just worried and want accurate information.

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The Crazy Coronavirus 'Cures' on the Chinese Web Include Trump's Secret 'Super-Drug' - The Daily Beast

The University of Alabama at Birmingham (UAB) is already considered a national leader in precision medicine. Now, the university has proposed a project that could transform the Birmingham metropolitan area and the entire state for generations to come. The only catch? A final portion of funding from the State of Alabama is needed to make the project a reality.

First, some background.

Precision medicine focuses on individual patients to understand how their lifestyles, behavior, environment and genetics interact to affect their health. More importantly, precision medicine allows a systematic approach to integrate these key factors into the prevention, diagnosis and treatment of disease all tailored to each and every individual patient.

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Essentially, what UAB does in its world-class precision medicine practice in partnership with top-notch Alabama entities like HudsonAlpha and Southern Research is: (1) sequence a patients whole genome or a specific tumors genome; (2) then evaluate that sequence for a mutation(s); (3) use a massive and continually growing database to determine what effect any given mutation has on a patient; (4) cross-reference that mutation with all known compounds or drugs to (5) determine a treatment plan for the patients condition.

This process cures rare diseases on a regular basis. The story of UABs own Matt Might, considered a preeminent international leader in the field, epitomizes what precision medicine is all about.

Between May 2016 and April 2019, UABs precision medicine practice successfullydeveloped research plans for 90 patients who were each previously believed to have an undiscoverable rare disease. Additional patients were also referred directly to an appropriate program or specialist through UABs precision medicine process.

Moreover, UAB (through the Alabama Genomic Health Initiative) has repurposed approximately 10 existing medications for treating new disorders through the precision medicine practice. Examples are as simple as over-the-counter medications like Prevacid that UAB has discovered can be repurposed to treat a rare disease.

Simply put, the results have been staggering just in the first few years of UABs precision medicine focus.

However, this could be merely the beginning a prelude to historic things to come.

To really establish itself as the unequivocal global leader in genomic medicine and data sciences, UAB is committed to renovating and outfitting a state-of-the-art genomics facility.

The university has already secured a generous $10 million donation from Lee Styslinger III and the Altec-Styslinger Foundation. As such, UAB plans to name the building the Altec-Styslinger Genomic Medicine and Data Research Building.

UAB has further secured $8 million in federal funding.

Yet, to get the facility done, another $50 million is needed. UAB is asking the state for this amount through anAlabama Public School and College Authority bond issue. Governor Kay Ivey chairs the authority.

The university also plans to pursue local government funding from both the City of Birmingham and Jefferson County.

The University of Alabama System, in which UAB is one of three campuses, argues that the payoff on the requested $50 million in funding for the state would be unquestionably worth it in multiple ways.

First, the most tangible way is the estimated economic benefits of the project.

With this facility in place, UAB would recruit 50 researchers and an additional 300 support staff, meaning 350 high to very high paying jobs would be created. The university would spend $75-100 million recruiting this top talent over the next seven or eight years. UAB projects those researchers, when collaborating with the intuitions existing Hugh Kaul Precision Medicine Institute and Alabama Genomic Health Initiative, can generate $75-85 million in new funding.

Ultimately, leaders within the UA System believe that Birmingham would be set to become the Silicon Valley of Biomedicine with the facility operational.

Each rare disease discovered or treatment plan formed could, in itself, become a large spin-off healthcare startup company based in the Magic City. This has already happened once in the first few years of the precision medicine practice in the form of a leukemia drug screening service that identifies the best possible treatment for each individual leukemia patient.

At a meeting of the UA Systems board of trustees Friday at UAB, UA System Chancellor Finis St. John said that the UAB genomics facility could have a transformational impact on the Yellowhammer State similar to the likes of NASA and Redstone Arsenal, Mercedes-Benz and the Port of Mobile. He called the project a once in a lifetime opportunity.

St. John said this is an opportunity to improve the lives of our citizens in a way which may never occur again.

Watch his powerful remarks:

St. Johns urgency was echoed by each trustee on Friday. Board members made passionate pleas for the state to support this unprecedented effort.

It should also be noted that it is not just officials associated with UAB or the UA System leading the charge on this project.

Every member of the Jefferson County state legislative delegation (who essentially never unanimously agree on anything) has signed a letter of support for the project, calling for the facility to be funded.

Senators wrote in their respective joint letter in 2019, stating, The economic impact of this project cannot be overstated.

This letter was authored by Senate Rules Committee Chairman Jabo Waggoner (R-Vestavia) and signed by Senate Majority Leader Greg Reed (R-Jasper), State Sen. Rodger Smitherman (D-Birmingham), State Sen. Linda Coleman-Madison (D-Birmingham), State Sen. Shay Shelnutt (R-Trussville), State Sen. Dan Roberts (R-Mountain Brook) and State Sen. Priscilla Dunn (D-Bessemer). House members signed onto a separate letter echoing similar sentiments, and U.S. Senator Richard Shelby (R-AL) backs the project and helped secure the federal funding component.

Here is a snippet from the state senators letter:

Waggoner and Smitherman attended the board of trustees meeting on Friday to emphasize their staunch support for the project.

The State can provide this support (the requested funding), and the State should provide this support because nothing that the State could do [with the funding] would be more important to the future of this state, St. John said.This is not a project to benefit UAB. Its not a project to even benefit the University of Alabama System. It is a project for the future of the citizens of Alabama.

Because, while the economic impact of the project could be unparalleled, there is a bigger factor in play, the greatest of them all: peoples lives.

Ivey has said that every life is a sacred gift from God.

UABs genomics facility would undoubtedly save countless lives and improve the quality of others. That return on investment is quite simply priceless.

Sean Ross is the editor of Yellowhammer News. You can follow him on Twitter @sean_yhn

Excerpt from:
Roby: Preventative actions to take during flu season - Yellowhammer News

Professor Geoffrey Tofler

Bereavement following the death of a loved one is one of the most stressful experiences to which almost every human is exposed, said Professor Tofler, Professor of Preventative Cardiology at the University of SydneysFaculty of Medicine and Health, and Senior Staff Cardiologist at Royal North Shore Hospital.

Our study isthe first clinical trial to examine how the cardiac risk factors could be mitigated during early bereavement.

The research team from the University of Sydney, Royal North Shore Hospital and the Kolling Institute enrolled 85 spouses or parents in the study within two weeks of losing their family member.

Forty-two participants received low daily doses of a beta blocker and aspirin for six weeks, while 43 were given placebos. Heart rate and blood pressure were carefully monitored, and blood tests assessed blood clotting changes.

The main finding was that the active medication, used in a low dose once a day, successfully reduced spikes in blood pressure and heart rate, as well as demonstrating some positive change in blood clotting tendency, said Professor Tofler.

The investigators also carefully monitored the grief reaction of participants.

We were reassured that the medication had no adverse effect on the psychological responses, and indeed lessened symptoms of anxiety and depression, said Professor Tofler.

Encouragingly, and to our surprise, reduced levels of anxiety and blood pressure persisted even after stopping the six weeks of daily beta blocker and aspirin.

Co-investigator Associate ProfessorTom Buckleysaid the study builds on the teams novel work in this area with their earlier studies among the first to identify the physiological correlates of bereavement.

While beta blockers and aspirin have been commonly used long term to reduce cardiovascular risk, they have not previously been used in this way as a short-term preventative therapy during bereavement, said Associate Professor Buckley of the University of Sydney Susan Wakil School of Nursing and Midwifery.

The authors acknowledge that larger long-term studies are needed to identify who would benefit most however the findings provide encouragement for health care professionals to consider this preventative strategy among individuals that they consider to be at high risk associated with early bereavement.

Our finding on the potentially protective benefit of this treatment is also a good reminder for clinicians to consider the well-being of the bereaved, said Associate Professor Buckley.

Future studies are needed to assess if these medications could be used for other short periods of severe emotional stress such as after natural disasters or mass bereavement where currently there are no guidelines to inform clinicians.

Co-investigator Dr.Holly Prigerson, Co-Director of the Center for Research on End-of-Life Care at Weill Cornell Medicine in New York, said, This is an important study because it shows ways to improve the physical and mental health of at-risk bereaved people. It is a preventive intervention that is potentially practice-changing, using inexpensive, commonly available medicines.

People experiencing cardiac symptoms should discuss their condition with a health care professional before taking medication as incorrect use could be harmful.

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Common medication may lower risk of broken heart during bereavement - News - The University of Sydney

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The thermal baths complex of the Balneario of Archena has been in use since the time of the Roman occupation of this part of the Iberian Peninsula in the third century BC and offers a full range of thermal spa leisure options including thermal baths, thermal spa circuit, health and beauty treatments as well as a hotel and restaurant complex which is open throughout the year.

At the heart of the Balneario is the water which emanates from a natural spring at a temperature of 52.5 degrees Celsius and with a high mineral content which makes it particularly beneficial for treating sore joints and also facilitates the natural repair processes of the skin.

The Spa Centre itself offers extensive facilities, with an innovative indoor-outdoor thermal circuit experience complemented by a wide range of medical, beauty and relaxation treatments, attracting both visitors on courses of therapy (principally related to respiratory conditions, articulatory problems and stress) and those looking for a period of relaxation and pampering.

In addition, the thermal bath complex in Archena, it has to be said, is one of the most attractive places in the Region of Murcia, set as it is in the lush greenery which thrives on the banks of the River Segura at the southern end of the Ricote Valley.

Treatment, massage, saunas and recreational areasThere are three main areas at the Balneario de Archena offering therapeutic, beauty and relaxation treatments and recreational activities.

1. The Balnea thermal spa circuit (circuito Termal Balnea). This is a comprehensive and extensive spa circuit in which bathers pass through a wide range of different elements both inside and outside of the spa complex.

The Balnea Thermal Spa Circuit includes various saunas at different temperatures and levels of humidity, one of which is heated purely by the water of the spring while others use a variety of techniques. In addition there is a cross-current pool of minero-medicinal water with a temperature of 30 to 31C, a lemon pool (with fresh lemons floating in water at a temperature of 34 degrees), a flotation pool providing conditions similar to the Dead Sea, a cold water pool at 20 degrees, an igloo at approximately 2C, contrast showers, corridors containing alternating jets of warm and cool water, warm hammocks and infrareds.

The facilities also include onsite eateries in the Termalium area at the La Piscina snack bar and the Restaurante del Agua.

In addition, a wide range of beauty and health treatments (including facials, massages etc) are offered in the Centro de Esttica The beauty treatments include facial cleansing, oxygen Termalium (cleansing and hydration), Termalium Caviar (exfoliation and relaxation massage), cell refreshment anti-aging therapy, cleansing and collagen veil, hydration, face and scalp massages, beauty body massages, chocolate massage, chakra stone massage, psychosomatic Ayurveda, cellulite draining massage, peeling massage, lymphatic body drainage, foot reflexology, slimming and firming treatment and a vitamin C citrus bath.

The beauty centre is open:

Monday to Saturday from 10:00 to 14:00 and 16:00 to 20:00Sunday from 10:00 to 14:00 and 15:00 to 19:00. (see feed below for full information)

PricingA complete 2-hour circuit of the facilities in the Balnea spa area of the Balneario de Archena is priced at 25 euros during the week and 35 euros at weekends for those who are not staying at the hotels in the complex: guests at the Hotel Termas, Hotel Levante and Hotel Len receive a 5-euro discount.Open: 7 days a week from 11:00 to 21:00Age limit: 14. Minors aged 14-18 must be accompanied by an adult.

2. SPA Thermal swimming poolsThe swimming pools of the Balneario de Archena are filled using the waters of the thermal spa and provide year-round fun and relaxation for adults and children both indoors and outdoors.

For youngsters there is an additional special pool with slides, and also an area which generates a current around a small circuit, which is particular popular! For the grown-ups, meanwhile, there are two main pools, one indoors in the lush green setting of the Balneario and the other under cover, and a series of Jacuzzis and jet showers.

Full-day tickets here are priced at between 10 euros and 22 euros for adults depending on the time of year, with discounts for children (7 euros to 12 euros) and for evening-only sessions. Whole-day visits are recommended, allowing a chance to eat at the bar or the Restuarante del Agua.

Under-18s must be accompanied by an adult.

The swimming pools are open between November and March from 10.00 to 21.00, from March to June and from 1st September to 31st October between 10.00 and 22.00, and in July and August from 10.00 until midnight.

Full pricing is as follows:November until March open from 10:00 to 21:00Weekdays: adults 10, evening-only admission 7 (from 18:00), children 7.Weekends and public holidays: adults 17, evening-only admission 13 (from 18:00), children 11.March until October, plus 2nd to 10th December and the Christmas period: March to June and from 1st September to 31st October between 10.00 and 22.00, and in July and August from 10.00 until midnight.

Weekdays: adults 14, evening-only admission 8 (from 19:00), children 8.Weekends and public holidays: adults 22, evening-only admission 15 (from 19:00), children 12.

NB: During July and August the night-time reduced price period begins at 21:00 with the facilities closing at midnight

3. The thermal baths on the underground floors of the Hotel TermasIn this area of the Balneario a wide range of thermal treatments is available.

Most of the properties of thermal therapy lend themselves to both therapeutic and preventative medicine, particularly in the fields of respiratory and articulatory problems (painful joints) as well as countering stress, and the results achieved at the thermal baths in Archena are extremely positive, providing an improvement in quality of life for patients by reducing pain, improving mobility and lessening the dependence on pharmaceuticals.

The facilities on the second basement level of the Hotel Termas have been awarded the seal of quality by the Spanish tourist authorities, and a fully qualified medical team is present to oversee treatments and to prescribe them.

See feed below for full range of treatments available, ranging from 14 and 45 euros. See feed below for full details of how to book, price lists and treatment descriptions.

Therapeutic treatments

Treatments are prescribed by the onsite medical team, which includes three specialists in hydrology who perform an exhaustive initial check on all customers staying in the hotels and monitor their progress minutely. The treatments available in the spa underneath the Hotel Termas include the following:

Archena massage: the flagship treatment at the Balneario consists of a massage using thermal mud which is then showered off with water from the thermal spring. This is particularly effective at reducing muscle spasms and tension.

Thermal mud: a clay poultice containing thermal water is applied to the joints at a temperature of 45C. Beneficial for rheumatic diseases, painful musculo-skeletal conditions and the effects of trauma.

Termarchena: a small thermal circuit consisting of a steam room, a thermal water pool at 37C, a corridor with contrast showers (hot and cold) and two cabins providing 5-7 minutes of manual friction with mud and ice on the back.

For respiratory conditions there are also facilities for steam from the thermal spa to be breathed in directly, and a host of other therapeutic and physiotherapeutic options are provided.

All of the above are located in the Roman baths under the Hotel Termas, but the Balneario complex also includes numerous other treatments, all using the spring water, in the Balnea thermal circuit.

Hotel accommodation

Hotel Thermas (4-star)

Hotel Levante (4-star)

Hotel Len (3-star)

(Click for more information about the hotels or see feed below)

Practical details

What to take with you

Visitors to the Balneario de Archena are reminded to take with them a dressing-gown (white is preferred), at least one bathing costume, flip flops or similar, a bathing cap and a towel. For hotel guests the dressing-gown is included, and they can also be hired at the Balneario at a small extra cost.

Food, refreshments, souvenirs

Apart from the hotel dining-room restaurants in the Termas ( la carte) and the Len (buffet) there are also various other opportunities to grab a bite to eat or drink, including the chiringuito at the swimming pools, the cafeteria in the Casino (with its beautiful shady terrace), and a snack-bar. Another option is the Restaurante Del Agua, next to the swimming pools, and in summer the Bar Azul on the river bank offers live entertainment every Friday evening.

There is an onsite souvenir shop which also sells the most indispensable items for visitors: bathing caps, flip-flops, dressing gowns and swimwear!

How to get to the Balneario de Archena

Heading north from the city of Murcia on the A-30 motorway towards Madrid, take the exit at kilometre 121, where Archena is clearly signposted on the MU-554 road. Once approaching the town follow the signs for Balneario de Archena: these take visitors on a rather roundabout route, encircling the whole town before entering from the other side, so to speak, but trust the signs they do work!

The only sign which might be easy to miss is just about the last one, when the route appears to be taking visitors back out of town towards Villanueva del Ro Segura and Ulea. This is a right turn just after a Repsol petrol station: be on the lookout!

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Lunch and Spa thermal pools circuit for just 20 euros at the Archena Balneario - Murcia Today

Kim Kardashian West isnt eating meat anymore. And neither are her kids. For the most part, anyway.

According to a recent Twitter post, the Keeping Up With the Kardashians stay says her kids, Psalm, 8 months, Chicago, 2, Saint, 4, are all joining her in the plant-based diet with the exception of North, 6, who still eats fish.

Kardashian West announced last year that she was eating plant-based in a bid to help reduce her lifelong battle with psoriasis and psoriatic arthritis.

Before the arthritis hit, I spent about four months doing everything naturalevery ointment, cream, serum, and foam you can possibly imagine and everything from the dermatologist, she wrote in a blog post on her sister Kourtneys Poosh website. I even tried an herbal tea that tasted like tar. I tried celery juice for eight weeks. Then Id do celery juice mixed with the tea. I would do that twice a day. I was just exhausted by everything. I changed my diet to plant-based (which I still follow).

She said that she works to reduce stress and take time for herself so that she is centered. And diet still plays a role: I live a healthy life and try to eat as plant-based as possible and drink sea moss smoothies, she wrote.

The reality star also recently shared the contents of her refrigerator. The photos revealed a number of Beyond Meat products and lots of produce.

Kardashian West isnt the only parent raising kids on a plant-based diet. A growing number of schools are offering students meatless meals, too.

In New York, the citys public schools are all offering Meatless Monday menus. The Los Angeles school district has also been expanding its vegan lunch offerings.

Filmmaker James Camerons wife Suzy Amis Cameron runs the MUSE School in Los Angeles County. It only serves students vegan meals and was the inspiration behind Amis Camerons One Meal a Day program and book. According to Amis Cameron, going vegan just one meal a day for a year saves up to 200,000 gallons of water and reduces as much gas equal to a road trip from LA to New York.

Summary

Article Name

Kim Kardashian West Is Raising Her Kids on a Plant-Based Diet

Description

Kim Kardashian West and Kanye West are following the trend of raising kids on a plant-based diet for their health and the climate.

Author

Jill Ettinger

Publisher Name

LIVEKINDLY

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Kim Kardashian West Is Raising Her Kids on a Plant-Based Diet - LIVEKINDLY

Before 2011, if you had chest pain and went to what was then Great Plains Regional Medical Center, theyd run non-invasive tests, like an echocardiogram.

If you showed signs of a heart attack, youd probably be given a medication that dissolves blood clots and then flown to a larger hospital. That medication, called a thrombolytic, can restore blood flow to the heart in most people. But time is muscle, and if flow isnt completely restored, there can still be muscle loss.

Maybe you wouldnt even go to Great Plains for medical help, as was noted in a Sept. 1987 Telegraph article: Although the hospital has equipment and qualified doctors to provide heart tests, heart patients often leave North Platte.

There are a fair number who leave town because we dont have a cardiologist, (hospital president Cindy) Bradley said.

The hospital had a cardiac rehabilitation lab for people after they have a heart attack, but little to do to prevent or treat one.

In a county with one of the highest death rates due to cardiovascular disease in the state, the hospitals board decided in 2004 that something needed to be done to establish cardiovascular care in Lincoln County.

It began with a diagnostic catheterization lab: A place where tests can be done to determine if intervention is needed.

Patients who didnt have an active heart attack would be given a general cardiology work-up, which generally included an electrocardiogram measuring the electrical activity of the heartbeat and maybe a diagnostic catheterization passing a thin, flexible tube through the vessels in the heart to see how well the organ is functioning. Patients with a heart attack would be transferred to another hospital with treatment options.

Ivan Mitchell

As you can see, we had a lot of good diagnostic tools, but no intervention tools, said Ivan Mitchell, chief operating officer of Great Plains Health. With time being muscle for your heart, it took a lot longer to do treatment.

Cardiologys roots run deep

Humans have realized the importance of the pulse and the heart since ancient times: An unknown Egyptian physician describes the heart as the center of a system of vessels and seems to identify arterial fibrillation, a condition where the heart fails to beat with enough force to pump blood and that can cause cardiac arrest, according to a 1995 paper by Dr. James Willerson and Rebecca Teaff.

In the fourth century B.C., the philosopher Aristotle thought that the heart was the seat of intelligence, whereas the brain merely existed to cool blood.

In the second century A.D., the prominent physician Galen cited the liver as the source of veins, and said the heart was simply an organ blood passed through.

It wasnt until 1628 that the heart came back into the spotlight as the organ responsible for circulation. At that time, English physician William Harvey published his key work, in which he proposed that the heart pumps blood around the body with a single system of arteries and veins. The book included experiments and evidence backing that up, though others in the field were slow to accept his idea.

It took until the 20th century for physicians to link chest pain and hardening of the arteries with heart attacks, according to Dr. Rachael Hajar in her 2017 article on the history of coronary artery disease.

Getting blood pumping in the Great Plains

In 2011, the GPH board decided to move toward an interventional program they wanted to treat people right then and there if they came into the hospital with a heart attack.

They hired on a doctor, and added an interventional cath lab and clinic space. They added another doctor.

And then something happened.

What was really interesting was that we started to see the mortality rate decrease when that happened, Mitchell said, because if someone has an active heart attack, (the cardiology team) could do an intervention essentially right away.

The program couldnt seem to stop growing a second cath lab had to be added in 2018, and more doctors were hired.

Since 2016, weve had about 300% growth, Mitchell said. Weve really become a regional presence and referral center for our cardiology program.

The lab is a really, extremely busy cath lab, with 11 procedures alone taking place on the day Mitchell was interviewed.

The interventions include implantable medical devices, like the implantable cardiovascular defibrillator a battery-powered device that keeps track of heart rate and pacemakers, which help the heart beat in a regular rhythm. Even after the patient leaves the hospital with an implantable device, theyll still receive support from what Mitchell calls the Device Clinic.

If you have a pacemaker in and your heart throws a rhythm thats concerning, it will actually alert our Device Clinic, which will then alert the physicians, he said. Having that (clinic) here has been a great thing.

With all of the procedures available at GPH, some may be surprised to learn that the hospital doesnt have a cardiothoracic surgeon on site.

The data out there suggest that the programs without cardiothoracic surgery in hospitals have just as good of outcomes as programs that do have cardiothoracic surgery, Mitchell said. So what weve done is if someone comes in and their blockage is so severe that they need open heart surgery, we actually have a couple of tools that are used (until they can be transferred).

One of those options is a balloon pump, which is a balloon attached to a catheter. The doctor inserts it into the artery inside your upper leg and guides it to the aorta, or main artery, where the balloon inflates when the heart relaxes and deflates when it contracts. This allows the heart to pump more blood to the body using less energy, according to Johns Hopkins Medicine.

The other option is a device called an Impella, a mini heart pump that goes in like the balloon pump and works by drawing blood out of the heart and pumping it into the aorta, according to the Federal Drug Administrations page on recently approved medical devices.

(Acute interventions) really save lives, without any question, said Dr. Azariah Kirubakaran, an interventional cardiologist at GPH.

Until 1961, heart attack patients who made it to a hospital were simply placed in beds located throughout the hospital, far away from nurses stations, often with lethal results the risk of dying in a hospital from myocardial infarction was around 30%, according to Nabel and Braunwald.

Following that, cardiac care units where heart attack patients were closely monitored were implemented in general hospitals.

Balloon angioplasty and insertion of bare-metal stents were implemented soon after.

The first artery-to-artery anastomosis, known today as a cardiac bypass graft surgery, was performed in 1968 by Dr. George Green of Saint Lukes Hospital in New York. This surgery has become the absolute gold standard for bypasses, said Ludovic Melly and Gianluca Torregrossa in a 2018 article on the history of artery bypass grafting.

Cardiologists began to open blocked coronary arteries using streptokinase, a thrombolytic, in 1976.

In 1988, it was found that aspirin further reduced deaths in patients who had suffered heart attacks when used in conjunction with a thrombolytic.

These leaps and bounds in treatment are so recent that Kirubakaran can recall what he calls the dark ages during the early days of his own career.

I have personally seen people just die like flies, basically, back in the 80s, when they had heart attacks, Kirubakaran said. Compared to that, its a night and day difference. Even though I cant say that nobody dies of a heart attack thats not true the risk has been tremendously reduced with all the technologies we have, and its getting better every year.

For as many patients who have sought treatment, GPH is also trying to make sure some patients dont get to that point.

Dr. Azariah Kirabakaran

(Prevention) is a lot more attractive than trying to fix something once its happened for a variety of reasons: One, it doesnt put patients at risk at the time of the expression of the disease, Kirubakaran said. Secondly, its a lot less expensive to do so. And now there are ways of prevention that can be applied to large populations and it can be helpful to do so.

The Heart Institute at GPH has started offering a discounted cardiac screening to help patients determine their risks.

There are a lot of people who theyve caught those heart issues early on because of (the screenings), Mitchell said.

One of the components of that screening is calcium scoring, which measures the build-up of calcium in arteries. The greater the amount of calcified plaque, the higher the risk of heart disease.

But one of the most mundane things is also one of the best ways to catch heart problems early.

The most basic thing is to get your physical: Check your bloodwork, check your blood pressure, all that good stuff, Mitchell said. Ensuring that youre established with your primary care provider is also important because they can track your health over time and identify any worrying trends.

In spite of all of the treatment, diagnostic and preventative measures, Kirubakaran and Mitchell still feel that the program has more room to grow.

Kirubakaran hopes the program will be able to move toward doing more than just treating blockages with catheters.

We can replace some other valves at least with catheter-based techniques, which are a lot less invasive. It can be tolerated even by people who are very, very frail. Even seven or eight years ago, that was something unimaginable, but now its almost routine, Kirubakaran said.

Another thing that Kirubakaran hopes to see is cardiac MRI, which would allow them to see the heart in greater detail.

Studies show that the MRI is probably a lot more acurate of a stress test than any other test we can run. he said.

Mitchell also spoke on the possibility of eventually bringing an electrophysiologist to GPH, someone who would deal with electrical impulses in the heart and would be able to burn or scar heart tissue causing irregular heartbeats, a procedure known as an ablation. Much like in a house, one person cant necessarily fix everything.

Your interventional cardiologist is like a plumber theyre making sure the pipes are working and that the blood is pumping through your system, Mitchell said. An electrophysiologist is considered the electrician, and theyre making sure the rhythm is proper.

Technological advances are changing the ways cardiovascular disease is approached.

Kirubakaran described a medication being developed that would lower bad cholesterol by 40% to 45% with a single shot once a year.

A lot of people are already looking at it in terms of preventing large populations of people (from further developing heart disease), Kirubakaran said. It turns out that the longer your blood vessels are exposed to bad cholesterol, the higher the liklihood of developing a blockage. Being able to reduce the amount of bad cholesterol would therefore reduce the risk.

The Human Genome Project, where researchers sequenced and mapped all of the genes in Homo sapiens, was completed in 2003 and gave more insight into genetic components of diseases. Kirubakaran discussed the implications this research has in treatment of cardiovascular disorders.

Now there are a lot of things we know about atrial fibrillation, congestive heart failure, coronary artery disease, cardiomyopathy these all have some genetic background to them. How much genetics has a role to play and how much environment has a role to play, those are variable depending on an individual patient, Kirubakaran said. But now we are having more and more success figuring out how much genetics is playing a role, which can lead to better therapies that target the genes causing the diseases.

Kirubakaran is looking to a future without heart attacks.

Once theres a heart attack, its a messy thing. Theres no easy, clear-cut solution, Kirubakaran said. So if my patients never get to that point, Ill be really happy.

View original post here:
At the heart of our own history: Cardiology sees changes in North Platte and beyond - North Platte Telegraph

To mark World Cancer Day, an international day to raise awareness of the disease, NoCamels is highlighting some recent medical developments in Israeli cancer research, treatment, and care all from 2019-2020.

Why does cancer therapy help some patients and not others? That is a question Israeli Professor Yuval Shaked of the Technion Israel Institute of Technology in Haifa has been trying to answer with his latest medical research. Shaked recently published a study in Nature Reviews Cancer, a monthly review journal covering the field of oncology, that delved into how understanding and predicting individual host responses to cancer therapy can significantly improve care.

The initial cancer treatment phase can be often successful, but many patients are affected by the development of resistance, characterized by tumor relapse and/or spread, the Technion said in a statement.

The majority of studies devoted to investigating the basis of resistance have focused on tumor-related changes that contribute to therapy resistance and tumor aggressiveness, Shaked wrote. But over the past decade, the diverse roles of various host cells in promoting therapy resistance have become better understood. The current understanding is that cancer therapy can induce local and systemic responses in the patients body, and these actually support the resurgence of cancer and its progression.

Current modern immunotherapy has revolutionized cancer care, Shaked said in a Technion statement. However, despite considerable advances in cancer treatment, most patients do not respond to therapy at all or from a particular stage. Without the ability to predict the effectiveness of treatment, many suffer from disease recurrence or spread, which sometimes erupts with even greater violence.

Over the years, many have investigated and are still investigating the effect of therapy on the tumor itself, but few have analyzed the effect of the therapy on the patient, he pointed out.

This shift in focus can produce better care and help advance personalized and precision medicine, he indicated.

We are not saying that existing treatments are not good, he emphasized in the statement. They just arent suitable for everyone. Each treatment triggers a host response, and when this response exceeds the therapy effect, we receive ineffective treatment. For the therapy to be effective at the specific host level, it is important to predict the same counter-response and try to block it. This is how we will gain much more effective therapy.

Shaked is the head of the Technion Integrated Cancer Center and the chief scientific advisor of OncoHost a company he founded that uses response profiling to improve personalized cancer therapy.

OncoHost recently opened a new state-of-the-art laboratory in Binyamina for this very research and has already begun clinical trials in Israel. The company is in talks to start trials in Europe and the US, Shaked said,

It was recently awarded a $1 million grant as part of the Binational Industrial Research and Development (BIRD) Foundation to advance its research.

For immunotherapy, one of the most important effective approaches today in the field of cancer, only some 20-30 percent of patients today respond. Through blood testing, we can predict the outcome of patients treated with immunotherapy and continue such treatment only in patients in whom treatment is expected to be effective, he said.

Based on the present study, in the future, we may offer combined therapies to increase the effectiveness of treatment or allow patients who are currently unresponsive to immunotherapy drugs to respond to them. This is a huge revolution that we must advance not only in research but also in the commercialization of research into actual therapies. Only then can we contribute to saving lives, he added.

Israels Alpha Tau Medical, an Israeli medical technology company that developed breakthrough radiation cancer therapy, announced late last year that initial results of a preclinical trial have proved very promising.

Alpha Tau Medical was founded in 2016 to focus on R&D and commercialization of its breakthrough cancer treatment, Alpha DaRT (Dffusng Alpha-emtters Radaton Therapy). The technology, initially developed in 2003 by Professors Itzhak Kelson and Yona Keisari at Tel Aviv University, delivers high-precision alpha radiation that is released when radioactive substances decay inside the tumor, killing cancer cells while sparing the surrounding healthy tissue.

The first clinical trial of the treatment was conducted in Israel and Italy starting in 2018. The trial was designed to establish the safety, feasibility, and efficacy of the companys Alpha DaRT technology for patients with squamous cell carcinoma of the skin and head and neck area.

The results, published in the International Journal of Radiation Oncology, Biology, and Physics, showed nearly 78.6 percent of 28 patients received a complete tumor response rate. That means the patients all responded to the alpha radiation treatment in some way.

Overall, these impressive outcomes serve as an excellent basis for future trials in other tumor types, said the principal investigator of the trial Prof. Aron Popovtzer, MD, from Rabin Medical Center in Israel. The Italian arm of the trial was led by Dr. Salvatore Roberto Bellia from the IRST (Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori).

Future clinical trials will also investigate Alpha DaRT in other oncology indications, as a monotherapy or in combination with various systemic therapies.

Late last year, Israeli scientists said a new study they conducted showed that a small molecule called PJ34 triggered the self-destruction of human pancreatic cancer cells in mice.

According to the research,publishedin the peer-reviewed open-access biomedical journal Oncotarget, the administration of the molecule reduced the number of cancer cells in developed tumors by up to 90 percent in 30 days.

The study was led by Professor Malka Cohen-Armon and her team at Tel Aviv Universitys Sackler Faculty of Medicine, in collaboration with Dr. Talia Golan and her team at the Cancer Research Center at Sheba Medical Center, and conducted with transplantations of human pancreatic cancer cells into immunocompromised mice, or xenografts.

Professor Cohen-Armon indicated that the mechanism, tested in parallel studies, acted efficiently in additional types of cancer, eradicating a variety of resistant cancer cells (breast, lung, brain, and ovarian cancer) including types resistant to current therapies.

PJ34 is being tested in pre-clinical trials according to FDA regulations before clinical trials on larger animals and then humans begin, Tel Aviv University said in a statement at the time.

Dr. Golan is a lead researcher at the Pancreas Cancer Olaparib Ongoing (POLO) Clinical Trial at the Sheba Medical Center.

This past summer, NoCamels reported on Dr. Golans work on a drug regimen that proved promising for some pancreatic cancer patients, specifically those with advanced stages of the disease as well as a BRCA 1 or 2 germline mutation.

BRCA1 & 2 are tumor suppressor genes, meaning that those with the deleterious mutation have a higher lifetime risk of developing cancer. The gene is predominantly linked to breast and ovarian cancer, but several studies name pancreatic cancer as the third most common cancer associated with these mutations.

Among patients with pancreatic cancer, onlyfour to seven percent have this gene variation, so Dr. Golans clinical trial team looked for participants from across the world.

Dr. Golan tested the effectiveness of a drug regimen that featured a PARP inhibitor called Lynparza, the trade name for the biological agent olaparib.The drug blocks the production of Poly ADP-ribose Polymerase (PARP), a protein that repairs DNA in tumor cells.

Her study, published in the New England Journal of Medicine, explained: PARP inhibitors cause an accumulation of DNA damage and tumor-cell death. The PARP inhibitor olaparib has been shown to have clinical efficacy in patients with a germline BRCA mutation and ovarian or breast cancer.

The results of the Phase III randomized, double-blind study with a placebo control group showed that, in essence, the drug treatment regimen stalls the progression of the disease. Of the 3,315 patients who underwent screening, 154 fit the study criteria to be assigned to trial intervention, thus 92 received the treatment and 62 received the placebo.

The median progression-free survival was significantly longer in the olaparib group than in the placebo group (7.4 months vs. 3.8 months), the study detailed.

Israeli and British scientists published a new study in October that showed that a simple blood test that relies on a DNA repair score proved effective for lung cancer screening.

The study was led by Professor Zvi Livneh and Dr. Tamar Paz-Elizur, both members of the Weizmann Institute Department of Biomolecular Sciences, alongside Professor Sir Bruce Ponder of the University of Cambridge and Professor Robert Rintoul from Royal Papworth Hospital and Cambridge.

Titled DNA-Repair Biomarker for Lung Cancer Risk and its Correlation with Airway Cells Gene Expression and published in the peer-reviewed journal the National Cancer Institute-Cancer Spectrum (JNCI-CS), the scientists study found that patients DNA repair scores a summation of the activity of three DNA repair enzymes (OGG1, MPG and APE1) through which cells are known to respond to genetic damage can significantly improve current lung cancer risk prediction, assisting prevention and early detection.

The study involved 150 British patients with non-small-cell lung cancer and a control group of 143 healthy volunteers. The scientists calculated each participants DNA repair score based on blood activity levels of three enzymes known to respond to DNA damage, the Weizmann Institutesaidin a statement.

They found that the DNA repair score of those with lung cancer was lower than the control group across the board, establishing this enzymatic activity as a robust biomarker for lung cancer risk independent of smoking.

The results, the Weizmann Institute said, validated a previous studypublished in 2014by Professor Livneh that examined DNA repair scores in an Israeli population, showing that the new approach could potentially be implemented to promote more effective lung cancer screening worldwide.

Reliance on age and smoking status as the two main risk factors isnt enough, as preventative screening in this selected population misses most lung tumors, the Israeli and British scientists wrote in their paper. Moreover, individuals who are not obvious candidates for screening remain unaware of the danger they may face leading to delayed treatment and poorer prognosis, they went on.

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Top 5 Recent Advances In Israeli Cancer Research And Treatment | Health News - NoCamels - Israeli Innovation News

Fifteen additional U.S. airports will begin screening for travelers who may carry the 2019 Novel Coronavirus (2019-nCoV),the U.S. Department of Health and Human Services (HHS) announced today (Jan. 28).

As the total number of confirmed cases in China continues to climb, U.S. health officials aim to prevent an outbreak at home while studying the newfound disease and developing treatments. "At this point, Americans should not worry for their own safety," HHS Secretary Alex Azar said during a news briefing today. For "the individual American, this should not [have] impact on their day-to-day life."

The purpose of expanding screenings from five airports to 20 is to identify ill passengers returning from China, and to educate travelers about symptoms of the coronavirus so that individuals can seek medical attention if they suspect they may be infected, added Dr. Nancy Messonnier, Director of the National Center for Immunization and Respiratory Diseases.

Local and state health officials, directed by the Centers for Disease Control and Prevention (CDC), remain on the lookout for travelers with signs of respiratory illness or fever who either traveled to China recently or could have made contact with an infected person. In addition, close contacts of infected individuals are being monitored for signs of developing illness; this precaution will help the CDC to catch additional cases and understand how the disease progresses through time, Messonnier said.

"The coming days and weeks are likely to bring more confirmed cases," as well as potential reports of human-to-human transmission within the U.S., said CDC Director Dr. Robert Redfield. But as of yet, "there is no spread of this virus in our communities here at home," he said.

Related: 10 Deadly Diseases That Hopped Across Species

Besides preventing a potential outbreak, CDC officials are developing diagnostic, therapeutic and preventative measures to take down the new virus. Chinese health officials have made the genetic sequence of the virus available online, and using that information, the CDC developed a "rapid" diagnostic test. The agency plans to share the test with domestic and international partners after verifying its accuracy.

As far as treating the viral infection goes, currently, "there is no proven therapy for coronavirus infection," said Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases. In China, a select number of patients are being treated with antiviral drugs, including Remdesivir, which was initially developed as an Ebola treatment, and a drug called Kaletra, made of two separate antiviral medications.

"There's no proven efficacy of these" against the new coronavirus, Fauci said. "That is why it's so important that we get isolates of the virus."

By gathering these isolates, or samples, of the virus from infected people, CDC officials hope to design a therapy that will train patients immune cells to detect and destroy the virus, Facui said. Similar treatments, known as monoclonal antibody therapies, were developed for the coronaviruses that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), but were only tested in petri dishes and animal models, he said. These in-development treatments also could potentially treat the new virus, but likely wouldn't target the bug specifically enough to be particularly effective, Fauci said.

The more isolates of the new virus the CDC can procure, the more "robust" and specific its treatment solutions will be, Azar added. The agency hopes to deploy representatives on the ground in China to study isolates from infected people at the epicenter of the outbreak. The Chinese government will allow international experts from the World Health Organization to work on "increasing understanding of the outbreak to guide global response efforts," according to a statement published Jan. 28. The extent of U.S. involvement has not been clarified yet.

Related: Top 10 Mysterious Diseases

In the meantime, CDC officials are already in the midst of developing a candidate vaccine to innoculate individuals against the new virus. Using the data shared by Chinese health officials, the agency identified a "glycoprotein spike" on the virus' surface that enables the bug to enter host cells. The spike shall serve as an "immunogen" for the vaccine, meaning that the medicine will recognize the virus by binding to the structure, Fauci said.

Fauci said that he predicts, "with some cautious optimism," that the CDC could launch aPhase 1 clinical trial of a potential vaccine within the next three months. This initial trial would test the safety of the vaccine; assuming that the results are positive, the agency would then evaluate the state of the outbreak before proceeding to a larger safety and efficacy trial.

"We are proceeding as if we have to deploy a vaccine we are looking at the worst scenario, that this becomes a bigger outbreak," Fauci said.

As compared to their secretive stance during the 2003 SARS epidemic, Chinese health officials have been "cooperative" in meetings with the CDC and other international partners, and forthright with sharing information, Azar noted. Thanks to this transparency, "within one week, the CDC had invented a rapid diagnostic test. Within two weeks, we have a candidate vaccine that we're working on," he said.

That said, the virus continues to spread rapidly in China, and until the U.S. can deploy researchers to the scene, health officials can only work with the data they have at home. Continued transparency is needed to answer important questions about 2019-nCoV, including where the virus came from, whether asymptomatic people can transmit the infection, and how many cases have truly occurred so far, Azar said.

Originally published on Live Science.

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Coronavirus screening expands to 20 US airports; researchers start work on a new vaccine - Livescience.com

Dr. McKibbens first-hand knowledge and experience in pediatric therapies, pediatric trials, preventative medicine, and clinical regulatory strategy, both at the FDA and in the Industry, make her an excellent addition to our team of Expert Consultants.

ROCHELLE, Va. (PRWEB) January 29, 2020

NDA Partners Chairman Carl Peck, MD, announced today that Dr. Linda McKibben, a former Pediatric Medical Officer/Clinical Reviewer in the Division of Vaccines and Related Products at the FDA Center for Biologics Evaluation and Research (CBER), has joined the firm as an Expert Consultant. Dr. McKibbens expertise includes pediatric therapies, pediatric trials, preventative medicine, public health, health policy, and clinical regulatory strategy.

Prior to joining the FDA, Dr. McKibben served in multiple roles at the US Centers for Disease Control and Prevention as Senior Advisor for Health Services Research at the National Center for Infectious Diseases (NCID), Senior Medical Officer in the Office of HealthCare Partnerships (OHP), and Medical Epidemiologist at the National Center for Prevention of Injuries (NCIPC). She has also served as a Senior Policy Analyst/Medical Director of Altarum Institute (Alexandria, Virginia), and Vice President of Health Policy at The Lewin Group (Falls Church, Virginia).

Most recently, she served as a Clinical Trials Medical Consultant for Ripple Effect Communications, where she supported the Deputy Director of Extramural Research at NIHs National Institute for Child Health and Human Development, and as a Medical Consultant in the Integrated Product Development Division of PAREXEL Consulting.

According to Dr. Carl Peck, Dr. McKibbens first-hand knowledge and experience in pediatric therapies, pediatric trials, preventative medicine, and clinical regulatory strategy, both at the FDA and in the Industry, make her an excellent addition to our team of Expert Consultants. We are very pleased to welcome her to NDA Partners.

Dr. McKibben earned her medical degree from the Medical College of Georgia, Doctor of Public Health degree in Health Policy from the University of Michigan, Master of Public Health degree from Harvard University, School of Public Health, and bachelors degree in microbiology/pre-medicine from the University of Georgia. She is a fellow of the American Academy of Pediatrics and board certified in preventative medicine.

About NDA PartnersNDA Partners is a life sciences management consulting and contract development organization (CDO) focused on providing product development and regulatory services to the pharmaceutical, biotechnology, and medical device industries worldwide. The highly experienced Principals and Expert Consultants in NDA Partners include three former FDA Center Directors; the former Chief Executive Officer and Chief Science Officer at the United States Pharmacopeial Convention (USP); an international team of more than 100 former pharmaceutical industry and regulatory agency senior executives; and an extensive roster of highly proficient experts in specialized areas including nonclinical development, toxicology, pharmacokinetics, CMC, medical device design control and quality systems, clinical development, regulatory submissions, and development program management. Services include product development and regulatory strategy, expert consulting, high-impact project teams, and contract management of client product development programs.

ContactEarle Martin, Chief Executive OfficerOffice: 540-738-2550MartinEarle@ndapartners.com

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Dr. Linda McKibben, Former FDA Pediatric Medical Officer, Division of Vaccines and Related Products, Joins NDA Partners - PR Web

January 28, 2020

By: Nigel Coke, Inter-American Division News, and Adventist Review

We are doing a fabulous job of not moving enough, Jason Aragon said as he started his presentation dubbed, Stand Up, Stand Up.

Aragon was referring to a global survey done on levels of inactivity for 2001 to 2016, which showed that 8 out of 10 adults and children do not engage in enough physical activities on a weekly basis and that this was a leading risk factor for non-communicable diseases, mental health challenges, and lower quality of life.

Highlighting figures from the survey, Aragon pointed out that inactivity was no different in all demographics, regardless of whether people are rich or poor.

Doing enough exercise, instead of sitting down daily, will help the oxygen flow to our bodies and in the brain, which will help to give us clarity of thoughts and make better decisions, said Aragon, who is the director of the graduate program in public health and preventative medicine at Montemorelos University in Mexico.

If you want to be rich in terms of your physical fitness, you are the master of your destiny, Aragon said. No other health behavior is as dependent on will power as is exercise, he added. You can be rich when it comes to physical fitness if you put in the work. You can deposit daily to that account.

The Power of Sedentary Behavior

In the Dallas Bed Rest Study of 1966, five individuals were tested for oxygen output and workload (strength) capability after three weeks of total inactivity on bed rest and then after eight weeks of intense physical training. Forty years later, those same five individuals were tested again. The individuals had maintained some regular physical activity over the 40 years. Researchers found that their oxygen output and workload capability had declined over the 40 years (because of aging) about the same amount as it had declined when the five individuals were put on total bed rest for three weeks in 1966. Muscle loss and lowered lung capacity had happened very quickly whenever they stopped physical activity altogether.

Muscle wasting is more accelerated when we are lying down or sitting for long periods than if we were doing physical activities thats the power of moving, Aragon emphasized after describing the Dallas study.

Aragon was presenting on the second day of a health summit hosted by the Inter-American Division (IAD) in Punta Cana, Dominican Republic, January 22-26, 2020. Attendees included church leaders and health ministry directors from across IAD.

During the presentation, the university professor engaged the attendees in physical exercises to illustrate and reinforce the need for physical activities.

In redefining retirement, Aragon posited that retirement is not about finding a place to sit but about being able to move and enjoy life and do things for yourself, not the sedentary lifestyle that was often the case during working life.

In concluding, he warned the audience that if they want to outwalk death, they would have to walk at a quicker pace than they were currently moving.

The muscles grow weaker as we get older. The stronger our muscles, the better we can combat aging. Move as if your life depends on it, because it does.

The original version of this story was posted on the Inter-American Division news site.

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Health Leaders Are Challenged To 'Get Up, Move, and Live Longer' - Adventist Review

There is one group that by their actions, rather than words, loves a good screening test; the top hospitals for heart and cardiac surgery, our premier academic medical centers. Researchers [1] called administrators at these top hospitals inquiring about their executive wellness programs. For the unacquainted, these executive wellness programs carry out half and one-day evaluations of executives, or the wealthy worried well specifically looking for diseases to be treated, as well as lifestyle, behavior modifications. Since the authors are cardiologists and cardiovascular disease remains the #1 cause of death they focused on the testing provided.

The Results

Of the 12 tests, none of them are recommended by the ACC/AHA (American College of Cardiology/American Heart Association), the USPSTF (United States Preventative Services Task Force, or ACPM (American College of Preventative Medicine) to be applied indiscriminately to asymptomatic adults.

And you can be sure that members of the faculty at all these institutions were involved in setting those standards. There are flaws, freely acknowledge, in the study. Most importantly, the information came from administrators, not the actual clinicians so perhaps these tests were not applied to everyone, without consideration of their symptoms or risk. And while we have the charges, in a world of medical opacity, we dont really know what was paid by insurance or out of pocket. But the researchers' final point is, to my mind, the most important, so I will leave them the last words.

In addition to clinical care, the top cardiology hospitals also provide medical education. Offering executive physicals with tests that are not recommended for healthy persons to anyone who can pay out of pocket potentially sends the message to trainees that a 2-tier health care system is acceptable, and that evidence is not important. Furthermore, indiscriminate screening can create a cascade effect and thus violate the principle of primum non nocere (first do no harm) wherein unnecessary tests may create a chain of events resulting in additional ill-advised tests or treatments that may cause avoidable physical or psychological harm.

[1] Researchers were from Washington University School of Medicine and the St. Louis School of Medicine not part of the top 20, so no conflict of interest although the cynical might cry sour grapes.

Source: Assessment of Cardiovascular Diagnostic Tests and Procedures Offered in Executive Screening Programs at Top-Ranked Cardiology Hospitals JAMA Internal Medicine DOI: 10.1001/jamainternmed.2019.6607

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A New Form of Health Inequality - American Council on Science and Health

Medical costs will continue to outpace general inflation by close to 3 times with the regional average expected to be 13.6 per cent in 2019, says the Mercer Marsh Benefits (MMB) Key Medical Trends in the Middle East and North Africa report.

This is anticipated to grow to 14 per cent in 2020. As the cost of delivering health benefit programmes continues to rise across the region, employers are working with the likes of Mercer Marsh Benefits to develop smarter healthcare plans and embrace wellness and preventive medicine.

Regionally, the top three health risk factors influencing medical costs are respiratory conditions, diseases of the circulatory system and endocrine and metabolic diseases.

Type 2 diabetes remains a significant concern across the Middle East, with KSA having the highest prevalence of the condition (31.6 per cent) followed by Oman (29 per cent), Kuwait (25.4 per cent), Bahrain (25 per cent), and the UAE (25 per cent).

With several countries in the region looking to introduce mandatory healthcare regimes, employers will need to combat the over utilisation of benefits and the underutilisation of primary care. The commercialization of the hospital sector, together with the increasing availability of healthcare is driving an uptake in healthcare services and the resulting costs.

Employers face a challenge in balancing the cost of healthcare provision with the quality needed to meet regulatory standards and employee needs.

The top three causes for the increasing costs the region faces are; (1) the over prescribing of low-value health tests and procedures, (2) high cost pharmaceuticals and (3) overly lengthy inpatient stays.

Julio Villalon Garcia, Mercer Marsh Benefits Leader, Middle East & Africa, said: Although there are clear challenges facing us, the region is making significant investment into tackling some of the issues raised in this report, specifically by encouraging employees to take greater personal responsibility for their own well-being through more visible support for preventative care. The MEA region is a global leader in adopting virtual health consultancies and telemedicine, and 88 per cent of our respondents are either considering or already support this new technology the global figure is 78 per cent.

In time, I expect employees to develop a better understanding of their own healthcare needs. This, together with improved access to preventive care and simpler and more user-friendly technology, has the potential to allow medical inflation to be better managed. -- Tradearabia News Service

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Regional healthcare costs at 3 times the rate of inflation - Trade Arabia

Twin sisters have opened a vet surgery which treats pets with herbal remedies including mistletoe and medicinal mushrooms.

Reagan and Jordan Carnwath, 29, grew up 'obsessed' with animals and in their childhood would bring sick or injured creatures home to care for them.

The identical twins both studied veterinary medicine at the University of Glasgow, and Reagan graduated in 2013 with Jordan completing her studies a year later.

After finishing her studies, Reagan moved to Dumfries and Galloway to work in a rural veterinary surgery, but in 2017 she returned to her home city and established Herbal Vet Scotland.

Unlike most vet surgeries, regular services such as spaying and neutering are not performed at the practice, in Glasgow's South Side.

Instead, complementary holistic treatment is given in addition to regular medical care provided elsewhere, on a referral basis meaning medical records can be accessed.

Pet owners could be issued with recipes for meals to cook for their pets, and acupuncture could be performed as a form of pain relief.

But Reagan says the business is the 'first of its kind' in Scotland, and their patients include cats, dogs, and horses.

She stays at the Glasgow branch while Jordan travels further afield in Scotland to visit patients on their farms.

Reagan said: "We're the only dedicated herbal practice of its kind in Scotland.

"If animals need conventional treatments we'll send them back to their regular vets but we choose to model on holistic medicine and it seems to work well.

"In North America it's really big with vets that work in this way.

"It's important because it shows these treatments are effective.

"A lot of people worry about coming across a vet like us and wonder how effective it is.

"We're not replacing conventional veterinary care.

"We see a lot of animals with skin diseases and cancers.

"We're not saying 'we can cure cancer', but we have a whole lot of treatments we do such as injections of mistletoe and diet changes.

"One of our patients got diagnosed with a rare form of cancer of the adrenal gland and the vet said it would be weeks to months to live.

"We saw the dog and started him on weekly injections of mistletoe and now he's doing really well - he's full of energy and acting like a puppy again.

"We won't say we've cured him, but he's living a really good quality of life.

"He's on medication to control his blood pressure, that's the only conventional medicine he's on.

"He's also on a home cooked diet and medicinal mushrooms as well."

Both sisters believe that raw diets, including raw meat, can be beneficial to animals - but they also provide owners with recipes for home cooked meals.

Reagan, from Cambuslang, Glasgow, said: "We give the owners recipes and they cook them up at home.

"They cook a big batch up and can freeze it so it's not too time consuming.

"An advantage is you know exactly what's going on.

"Dog food can be quite processed with meat derivatives."

Herbal powders, creams and ointments are also prescribed as treatment, along with mistletoe injections.

Reagan said a home cooked diet and herbal treatments can be 'preventative' and keep animals healthier so they don't need as much conventional veterinary care.

She said: "Some conventional medicines like steroids are super cheap but others are really expensive.

"We offer puppy and kitten consultations to get diets right, reducing needs for over vaccination - setting them up to be as healthy for as long as possible.

"It's preventative.

"It's really the future of preventative medicine."

Reagan added: "Since little girls we were obsessed with animals and we've been lucky to grow up and realise our dream to become vets.

"We were animal mad and always bringing injured ones home to our mum, much to her delight."

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Scots twins open vets to treat pets with herbal remedies including mushrooms and mistletoe - Daily Record