June Hancock lived in the shadow of the J W Roberts asbestos factory at Armley.

For decades it spewed asbestos dust over the community. It closed in the 1950s, but more than 50 years later its activities are still causing deaths.

Mrs Hancock’s mother died of mesothelioma, an incurable cancer of the lung caused by asbestos. Mrs Hancock then contracted the disease in 1994 and sued the factory’s owners Turner Newall.

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The disease usually kills within 12 to 18 months of diagnosis.

Despite delays by the company’s lawyers Mrs Hancock lived long enough to win her case, opening the doors to compensation for hundreds of victims. She died in 1997. The June Hancock Mesothelioma Research Fund was established in her memory.

The British Lung Foundation is working with the fund to support new research which could lead to better treatments.

Dr Stefan Marciniak, who heads a research group at the University of Cambridge, has been awarded a two-year grant worth £118,839 for research into mesothelioma….

Through his research he hopes to gain a better understanding of why the cancer progresses. This will help scientists to create new ways of combating the disease.

Dr Marciniak said: “I am thrilled to be awarded the June Hancock Mesothelioma Research Fund grant by the British Lung Foundation.

“As a chest physician I treat patients with pleural disease. I hope to be able to take my findings out of the laboratory to improve the treatments available to my patients .”

Noemi Eiser, honorary medical director for the British Lung Foundation, said: “Someone dies from mesothelioma in the UK every five hours. This study could really make a difference.”

Kate Hill, spokeswoman for the fund, said: “The June Hancock Mesothelioma Research Fund is committed to supporting research that will find new ways to provide real benefits for patients.

via:yorkshireeveningpost.co.uk/

Australian scientists looked for the reason why people with Hepatitis C often go on to develop diabetes, and they made an unexpected discovery.

The heightened risk of type 2 diabetes was thought to be linked to fat build-up in the liver caused by their Hep C, but tests on people with the blood-borne virus found something else was awry.

The Garvan Institute of Medical Research study confirmed the 29 study participants all had ‘high insulin resistance’ – a precursor to diabetes – but the problem was traced to their muscle and not their livers….

Professor Don Chisholm said this result was ‘contrary to all expectations’.

‘… not only did we find no significant insulin resistance in the liver of the patients in the study, half of them suffered from a strain of Hepatitis C that causes about three times the normal level of fat to accumulate in the liver,’ Prof Chisholm said.

‘A number of important investigators around the world have been arguing that fat in the liver is an extremely important determinant of insulin resistance, perhaps the most important.

‘At least in this context, we’ve shown that not to be the case.’

Hepatitis C is a liver disease and one of its most common strains – Genotype 3 – is known to cause significant fat deposits in the liver.

Study participants with this strain were shown to have the same level of insulin resistance as those with no liver fat accumulation.

The two most important organs that respond to insulin in the body are the liver and muscle, Prof Chisholm explained.

An insulin-resistant liver produced unwanted glucose while insulin-resistant muscle could not absorb it from the bloodstream, leading to high levels of sugar in the blood.

‘More work now needs to be done into why Hepatitis C causes insulin resistance in muscle,’ Prof Chisholm said.

‘That will give us better insight into the behaviour of the disease.’

Hepatitis C is transmitted in Australia mainly by drug users sharing needles but also by non-sterile tattooing or body piercing and, unlike Hepatitis A and B, there is no vaccine.

Around 212,000 Australians suffer from chronic Hepatitis C and there are roughly 10,000 new infections each year.

Prof Chisholm conducted the research along with Dr Kerry Lee Milner also from the Garvan Institute, in collaboration with Professor Jacob George from the Storr Liver Unit at the University of Sydney and Westmead Hospital

via:bigpondnews.com

Kidney failure is the final stage of chronic kidney disease (CKD), a serious condition where the kidneys could no longer rid the body of wastes.

CKD is present when individuals have an increase in the excretion of albumin in the urine or a major decrease in kidney function.

In Malaysia more than 3,500 people develop end stage renal failure every year, giving rise to the number of patients requiring dialysis.

According to the president of Malaysian Society of Nephrology (MSN) Dr Philip N. Jeremiah, CKD affects about eight to 10 per cent of the population and currently the number of patients requiring dialysis in Malaysia is growing by 5 to 7 per cent annually….

This is partially caused by the rise of diabetes and hypertension, which increases the risk for kidney disease.

CHRONIC KIDNEY DISEASE

According to the National Kidney Foundation of Malaysia (NKF) the common causes of CKD include inflammatory diseases of the kidney caused by infections, obstruction in the urinary tract and inherited disorders like polycystic kidney disease.

In both developed and developing nations, diabetes and hypertension are increasingly the most common causes of CKD especially in older people.

Even when diabetes is controlled, the disease can lead to CKD and kidney failure.

In fact, 55 per cent of advanced kidney failure is due to diabetes and if not detected and treated effectively can lead to kidney failure and death.

People with kidney failure undergo either an artificial blood cleaning process (dialysis) or transplantation to receive a healthy kidney from a donor.

However, due to challenges in obtaining a new kidney for transplant, majority of kidneys patients opt for haemodialysis or peritoneal dialysis.

EARLY DETECTION IS CRUCIAL

Early detection is crucial as this can delay the progression of kidney disease and its related complications, stressed the chairman of the NKF board of managers Datuk Dr Zaki Morad Mohd Zaher.

Currently, Malaysia has 20,000 dialysis patients and looking at the high cost of dialysis the government subsidises the cost for the needy patients.

In Malaysia, 55 per cent of all new dialysis patients are diabetic and dialysis outcome are generally poorer in patients with diabetes.

Unfortunately, diabetes, in particular Type 2 diabetes, may go undetected for many years.

During this time, uncontrolled blood sugar levels may cause damage to tissues and organs such as the blood vessels, eyes and kidneys.

Kidney disease develops slowly and the symptoms only appear at a late stage.

With early detection, the individual can be treated early and the deterioration prevented or arrested at an early date. This can prevent or delay the need for dialysis.

Hence, an important measure for the prevention of diabetes-related diseases is to encourage all Malaysians at risk of diabetes to undergo simple health screening tests such as urine and blood tests.

WORLD KIDNEY DAY

Dr Zaki said although the NKF has 23 dialysis centres nationwide, it no longer focused on dialysis alone as public education plays a major role in increasing awareness on the early detection and prevention of kidney disease.

Furthermore, patients also need to be educated on the treatment options available to them to help them make informed decisions as to their treatment plan based on their condition and lifestyle, he said.

This is why the main aim of the World Kidney Day (WKD) this year is to promote the importance of early detection and prevention of kidney disease and to prompt Malaysians to check themselves for kidney disease through simple health screening.

The WKD 2010 commemorated on 11 March will be celebrated for the fifth year in more than 100 countries around the globe.

WKD is a global health awareness campaign focusing on the importance of kidneys and calls people to check if they are at risk of kidney disease.

In Malaysia, the NKF in partnership with the MSN and the Ministry of Health has planned a series of event and activities.

The theme for WKD 2010 is “Protect Your Kidneys – Control Diabetes”. This is a wake up call for all, as diabetes represents the leading cause of CKD worldwide.

HEALTH SCREENING

This year, the campaign hopes to raise awareness on the importance of controlling diabetes to prevent CKD.

“One of the direct causes of diabetes is unhealthy lifestyle and poor eating habits. Our aim is to educate and inform the public to take the first step in changing their lifestyle and eating habits.

“We believe health screening provides a wake up call to all Malaysians on WKD 2010 to take the first step to check on the state of their health,” said Dr Zaki when met after the press conference for the World Kidney Day 2010.

The NKF LifeCheck Mobile Health Screening Unit, a 40-seater customised bus with seven workstations, will be mobilised to embark on a campaign road show and free health screening for members of the public in Kelantan, Terengganu, Pahang and Selangor.

To date, NKF have screened 62,000 members of the public and more than 10 per cent have shown abnormalities in their blood and urine samples taken during the screening.

The newly appointed NKF ambassador, celebrity Chef, Datuk Chef Wan will also participate in the campaign by conducting cooking demonstration to bring home the message regarding healthy eating habits.

Many major hospitals nationwide will be conducting various activities in conjunction with WKD. These include poster exhibitions, health screening and public forums.

Members of the public who are interested to obtain more information on the NKF and WKD 2010 activities can contact the NKF hotline at 1300-88-3110 or log on to www.nkf.org.my.

via:bernama.com

The news service continues: “Defense Secretary Robert Gates and Secretary of State Hillary [Rodham] Clinton ‘have called for more funding and more emphasis on our soft power, and I could not agree with them more, the admiral said” (2/3).

In a “shift in thinking, Mullen said in his speech that policymakers now and in the future should consider the U.S. military not as a last-resort solution in a crisis, but as part of early American responses to conflicts and disasters,” the Los Angeles Times reports. “‘Military forces are some of the most flexible and adaptable tools available to policymakers,’ Mullen said. ‘Before a shot is even fired, we can bolster a diplomatic argument, support a friend or deter an enemy.’ Mullen emphasized that military power must be used alongside other government tools,” the newspaper writes (Barnes, 3/4)….

Mullen cited a 2009 speech by President Barack Obama and called for increasing investment in other departments, ”such as homeland security, intelligence, and the State Department, whose budget pales compared to massive Pentagon funding,” the Christian Science Monitor writes. “My fear, quite frankly, is that we aren’t moving fast enough in this regard,” Mullen said.

via:news-medical.net/

When firefighters are called to assist someone with a heart attack, they need only connect the person to a Medtronic Lifepak monitor and press a button to communicate a patient’s condition to hospital staff.

Alerts are sent to doctors’ smartphones and hospital computers. Included is a detailed chart of the patient’s heart rhythms. By the time firefighters deliver the patient to the hospital, the hospital is prepared. Hospital staff can bypass a diagnosis and begin treating the patient when he or she is rolled into the emergency room or cardiac catheterization lab.

Previously, firefighters described the patient’s condition to a doctor who would assess the patient upon arrival, slowing down the treatment process.

“The earlier we open up the artery, the more muscle we can save,” said Manoj Rawal, chief cardiologist at Del E. Webb. “It can make a huge difference.”

Stan Garretson, 74, says he is proof.

The Nebraska resident was visiting his sister in Surprise recently when he awakened with chest pains. Garretson’s wife, Ellen, called 911.

Four firefighters from Station 301 in east Surprise arrived and hooked Garretson up to the monitor and hospital staff received notifications seconds later, said Nathan Lewis, pre-hospital coordinator for Del E. Webb.

Everyone was ready when Garretson arrived at the hospital on Feb. 24. The new technology meant Garretson got the most necessary treatment about 15 minutes earlier than he would have in the past, Rawal said….

“It truly was a miracle,” said Garretson, who has since been released from the hospital. “If they did not have that new equipment, I would have died.”

The firefighters were thrilled. The pilot program, involving the Fire Department and the hospital, had been planned to start days later, on March 1. Capt. Gregg Pickett, engineer Chopper Vastine and firefighters Ben Lundberg and Elliott Espinoza had trained to use the monitor just the day before Garretson had his heart attack.

“It was pretty shocking to me, actually, seeing how quick they were able to get everything set up,” Espinoza said. “You couldn’t have asked for a better situation.”

To participate in the pilot study, the Fire Department replaced an out-of-service monitor with the $33,000 Lifepak monitor, Assistant Fire Chief Kevin Pool said. If the new equipment continues to prove its worth, Surprise firefighters plan to purchase new monitors. Now, only firefighters at Station 301 have access to the new monitor.

via:azcentral.com

A vaccine against mesothelioma, a cancerassociated with exposure to asbestos, has shown early promise in its first clinical trial.

The experimental vaccine is an example ofdendritic cell (DC)-based immunotherapy, in which the body’s own immune system is harnessed to target and destroy cancer cells.

In the vaccine, a sample of the patient’s ‘dendritic’ immune cells are mixed with proteins taken from their tumour.

When implanted back into the patient, these cells can then activate other elements of the patient’s immune system, known as T-cells, and encourage them to attack and destroy the tumour.

Researchers at Erasmus Medical Center in The Netherlands have previously shown that DC vaccinesbring about an anti-tumour response in mice and decided to test the technique in humans.

They enrolled ten people who had recently been diagnosed with a form of mesothelioma called ‘malignant pleural’ mesothelioma, and who had been previously treated with chemotherapy.

The team took a sample of dendritic cells from each patient’s blood, and exposed them to proteins from their tumours.

The dendritic cell samples were also exposed to a ‘marker’ protein called keyhole limpet hemocyanin (KLH).

Patients then received three injections of their ‘activated’ dendritic cells over a two-week period.

Publishing their findings in the American Journal of Respiratory and Critical Care Medicine, the researchers revealed that all ten patients had antibodies to the KLH marker in their blood, confirming that the vaccines had brought about an immune response.

Further tests on four of the patients’ tumours revealed that three of the tumours had got smaller, although this could not be conclusively or directly linked to the vaccine….

The researchers noted that eight out of ten patients developed flu-like symptoms after being vaccinated, but that all but one had recovered from these symptoms within 24 hours. There were no other serious side-effects.

Dr Joachim Aerts, a pulmonary physician at Erasmus Medical Center, revealed that the study is the first to investigate DC-based immunotherapy in patients with mesothelioma.

“The possibility to harness the potency and specificity of the immune system underlies the growing interest in cancer immunotherapy,” he said. “One such approach uses the patient’s own DC to present tumour-associated antigens and thereby generate tumour-specific immunity.”

Dr Aerts added: “We hope that by further development of our method it will be possible to increase survival in patients with mesothelioma and eventually vaccinate persons who have been in contact with asbestos to prevent them from getting asbestos-related diseases.”

Dr Jodie Moffat, health information manager at Cancer Research UK, said: “This study involved just ten people, and so much more research and testing is needed before we’ll know if this will be a viable and effective treatment for mesothelioma in the future. Mesothelioma can be very difficult to treat, so finding new treatments to help beat the disease is crucial.”

Source: Cancer Research UK

Suzette Allinger, 56, remembers the day in July of 2008 when she was diagnosed with breast cancer.

Allinger, of the Creve Coeur area, had gone to see Dr. Alan Londe, a general surgeon, after she’d had severe breast pain. His diagnosis of cancer couldn’t have come at a worst time.

Allinger, whose husband of 20 years, Justin, had been laid off from retail management the year before. They had no private health insurance.

But with a part-time job in the cosmetics field, she couldn’t qualify for Missouri Health Net, Medicaid or other government programs.

“As I was crying a bucket of tears, Dr. Londe told me to take a deep breath and talk to Gateway to Hope,” she said.

That suggestion changed her life.

Londe is one of many doctors and other medical providers who donate services and products to the non-profit Gateway to Hope.

Based in Creve Coeur, the organization arranges no-cost comprehensive medical care for breast cancer patients who lack sufficient financial resources or insurance, but are ineligible for assistance through state and federal programs.

It was founded in 2005 by Dr. David Caplin, of Frontenac, a plastic/reconstructive surgeon, and Dr. Marlys Schuh of Creve Coeur, an oncology breast surgeon.

Caplin recalls a patient who was the catalyst for establishing the organization.

“This young woman was the sole breadwinner for her kids and disabled husband. She made enough so she wasn’t qualified for Medicaid but couldn’t afford insurance,” he said….

The woman found a lump in her breast, but ignored it for years.

“By the time she was diagnosed, the tumor had spread and she was sick enough so she couldn’t work. By then, she finally qualified for Medicaid, but the cancer was incurable and her family was left with no source of income when she died. That was a Eureka moment for me,” Caplin said.

Thanks to Gateway to Hope, more than 130 “partner” doctors, nurses, surgical centers, hospitals, drug and medical equipment companies, community groups and other organizations donate a variety of services.

Those can include medical visits, surgeries, medicines, hormone and drug therapies, radiation, transportation to medical appointments, food, utility payments, counseling, childcare and other comprehensive care that, otherwise, could cost hundreds of thousands of dollars per patient.

“Since we started, we have provided comprehensive care to more than 115 women, and we recently helped our first male patient,” Caplin said.

Patients must meet eligibility requirements, with yearly income of 200 to 350 percent of the federal poverty level, said Amber Mabie, Gateway program nurse manager.

For example, someone in a four-person household earning from $44,100 to $77,175 is eligible.

“We find a way to provide everything, all at no cost to patients, ” Caplin said.

One of his donors is Dr. Melvin Maclin, of Kirkwood, a cosmetic/reconstructive surgeon who is treating Allinger through Gateway.

“I see 25 patients a day and, if one happens to be from Gateway, it’s not a huge impact on my practice. But it’s a huge impact on the life of an individual,” Maclin said.

Allinger agrees, adding Gateway helps patients navigate the system, coordinating care between doctors and facilities.

“Here, you feel empowered and guided. They make you feel like family,” Allinger said.

Caplin originally wanted Gateway to help patients locally.

“But my goal also was to come up with something that can be replicated elsewhere,” he said. “If we can save hundreds of lives here, imagine if we got doctors using this program as a template to launch programs in other cities.”

via:news.yahoo.com

Montreal alcohol rehabilitation educates New York DUI lawyers-client’s who can’t stop drinking need 2 before DUI court.

…

Can’t really believe the driving, but what the hell. Everyone gets a DUI or two. The first one was a misunderstanding, and this one is just a minor slip up. A working guy can’t even have a few beers after work anymore the cops are so strict. The plan was stop at the bar for a few beers with the boys after work. A few too many then call a cab. Don’t really remember getting in the car. Wasn’t the bartender calling a taxi? The judge will see. Just have to keep the shakes down while in court.

via:justicenewsflash.com

ESAs are the most expensive drugs reimbursed by Medicare in patients requiring long-term dialysis, costing the agency nearly $2 billion annually.

The new study, to be published March 3 in the Journal of the American Medical Association, zeroes in on which treatment practices for the anemia of patients on dialysis for severe kidney disease might be beneficial and which are potentially harmful. The finding: More-aggressive ESA treatment practices among the most-anemic patients were associated with better outcomes; by contrast, aggressive treatment of patients with milder red-blood-cell deficiencies was associated with increased mortality.

The study’s senior author, Wolfgang Winkelmayer, MD, ScD, associate professor of medicine at the Stanford University School of Medicine, conducted the research while on the faculty at Harvard Medical School.

The findings are certainly timely. Over the next four months, the U.S. Food and Drug Administration and the Centers for Medicare and Medicaid Services are set to review the use of ESAs in treating anemia in patients with chronic kidney disease. “Eliminating coverage or severely restricting marketability of ESAs might mean pouring out the baby with the bath water,” said Winkelmayer, “We give glimpses that show that such extreme action might not be warranted.”

Anemia, a common complication of kidney disease, is the result of too few healthy red blood cells, leading to a decrease in the blood’s ability to carry oxygen. There are currently three ESA products used in the United States to treat it: darbepoetin alfa, marketed by the biotech company Amgen as Aranesp, and epoetin alfa, marketed, respectively, by Amgen as Epogen and by Johnson & Johnson as Procrit.

While ESAs were approved for use for the treatment of anemia in 1989, questions have emerged in recent years over their safety for different subsets of patients…..

Cancer patients with anemia often initially respond well to ESAs, but studies have shown that ultimately the drugs can cause tumors to grow faster and shorten patients’ lives. As a result, on Feb. 16, the FDA unveiled a plan requiring physicians to complete special training before prescribing ESAs for cancer patients.

The new study looks at the safety of ESAs for a different patient population, comprising another major group of the drugs’ users: people with severe kidney failure requiring long-term dialysis treatment — also known as end-stage renal disease. The condition affects about 530,000 people in the United States and roughly 350,000 of them are on long-term dialysis, meaning they rely on a dialysis machine to do the work of their kidneys, typically undergoing three- to four-hour treatments three times a week.

“Clearly, recent trials have revealed potentially serious safety issues for ESAs in end-stage renal failure patients,” said Winkelmayer. “But until our study, no one has been able to link the findings from selected trial populations of a few hundred or thousand patients to the larger population of typical patients undergoing maintenance dialysis.”

In the decades since the first of these drugs gained FDA approval, researchers have tried to assess their impact on patients’ risk of serious, potentially fatal cardiovascular events, like a stroke or heart attack. Researchers had observed that patients receiving higher levels of ESAs had increased risk of these negative outcomes, but proof of a cause-and-effect relationship eluded them.

“Researchers have looked at this a hundred different ways,” said Winkelmayer. “It’s occupied a generation of drug safety researchers. Unfortunately, patients requiring lower ESA doses for the management of their anemia are inherently different from patients requiring larger doses — making it almost impossible to discern whether the inferior outcomes experienced by patients receiving high ESA doses were attributable to the medication itself or to differences in patient characteristics, which were usually poorly described in the available datasets.”

Winkelmayer’s collaborators were lead author M. Alan Brookhart, PhD, now at the University of North Carolina; three other former Harvard colleagues; and a scientist at Amgen, which provided funding to support the research.

Winkelmayer and his co-authors took advantage of a natural experiment created by the use of varying treatment protocols at dialysis centers throughout the United States. The team analyzed data on patients’ treatment with ESAs and intravenous iron at about 4,500 U.S. dialysis units, creating a unit-specific anemia management profile for each calendar year between Jan. 1, 1999, and Aug. 31, 2006. Then, the researchers determined the one-year mortality risk associated with the various management protocols.

“What we found was that the facilities treating anemia most aggressively with an ESA among people who were severely anemic, with a hematocrit of less than 30 percent, had better outcomes,” said Winkelmayer.

“But using ESAs most aggressively among those patients whose anemia was relatively mild, having a relatively high hematocrit of 36 percent and higher, was associated with higher mortality,” he added.

The hematocrit is the proportion of blood that consists of red blood cells; the lower the hematocrit, the more anemic the patient.

They found that patients treated in facilities that offered the most aggressive treatment for people with hematocrits above 36 had an 11 percent higher risk of mortality compared with those treated in facilities that had the least aggressive treatment.

More- or less-aggressive ESA treatment among patients with intermediate hematocrits had no impact one way or the other, Winkelmayer said.

“Findings for iron treatment followed a similar pattern,” Winkelmayer said. “Facilities with greater use of intravenous iron at low hematocrit had better outcomes, whereas more-aggressive iron use among patients with relatively higher hematocrit was associated with increased mortality.”

The finding could influence regulatory agencies’ decisions about reimbursement or labeling for ESAs. On March 24, the Centers for Medicare and Medicaid Services are convening a Medicare Evidence Development and Coverage Advisory Committee to review the available evidence on the use of ESAs to manage anemia in patients who have chronic kidney disease, and the FDA has already indicated that it will follow suit later this spring.

Aside from their use as anemia treatments, ESAs also have a history of use as a blood doping agent in endurance sports such as cycling and distance running.

Winkelmayer noted that more information is needed on ESAs’ effects over a longer time period, as this study was based on new dialysis patients with follow-up limited to one year. Further studies are also needed in patients with chronic kidney disease who do not yet require dialysis as well as in patients receiving peritoneal dialysis, a less common form of dialysis. This paper looked only at patients undergoing hemodialysis, the most prevalent form of dialysis.

“I’m not sure whether we can appreciate a full picture yet,” Winkelmayer said. “A very careful and differentiated look at the existing evidence will be required.”

via:redorbit.com